Rich Vaughn, IFLG: Abandoned Frozen Embryos

What to Do With Abandoned Embryos

The problem began decades ago, in the late 1970s, as soon as the first babies created via the then-new technology of in vitro fertilization began to be born. It drew little notice for many years, growing slowly and steadily as a side-effect of the revolution in fertility treatment and reproductive health. But as the technology improved, as more and more people turned to assisted reproduction technology, and as best practices for embryo implantation evolved, the problem mushroomed: What to do about the by now hundreds of thousands of unused and abandoned embryos, created through IVF and cryopreserved, that crowd the storage facilities of fertility clinics all over the United States?

In my role as chair of the American Bar Association’s Family Law Section Committee on Assisted Reproduction, I had the privilege of speaking on this topic as part of a roundtable discussion at the 2017 American Society for Reproductive Medicine (ASRM) Scientific Congress & Expo on Nov. 1. Among those participating in the roundtable were reproductive endocrinologist Dr. Craig R. Sweet; attorney Tim Schlesinger, who represented the winning party in a Missouri Supreme Court case over disposition of frozen embryos (McQueen v. Gadberry—see our article); Amy S. Erickson Hagen, quality assurance officer for long-term U.S. cryopreservation/storage company Reprotech; leading Texas ART attorney Greg Stern; Christina Miller, Chair of the ABA Family Law Section Committee on Alternative Families; and Liesl Nel-Themaat, Ph.D., andrology team leader and endocrinology lab supervisor at the University of Colorado’s Advanced Reproductive Medicine program.

A single round of IVF treatment can result in the creation of numerous embryos. In the early years of IVF practice, fertility physicians typically would implant multiple embryos in order to increase the chances pregnancy would occur. But the result of such multiple implantations was often multiple births, which increase risks both to the babies and the birth mothers. Even then, there were often many more embryos created than were used in the IVF procedure.

Over time, as the technology improved, doctors were able to implant fewer embryos with good success rates, and by 1998 the standard practice was to implant no more than two or three, choosing those that appeared strongest and most viable. The number of “left-over” embryos grew.

The issue has become highly politicized by conservative lawmakers and advocates who have attempted to enact “personhood” laws that define embryos (including frozen embryos) as “persons.” The advent of embryonic stem cell research drew even more attention to the ethical issue of using embryos for medical research.

In most cases, IVF patients are required to sign an agreement outlining the disposition of frozen embryos in the event of patient death, divorce or separation. The patient usually has the choice of discarding or destroying the embryos, donating them for use by another infertile patient, or donating them for medical research. Typically, the IVF clinic will store frozen, unused embryos for a period of time in the event the client wants to have more children at a later time, or the embryos may be transferred to a cryopreservation facility for long-term storage. In either case, the client pays a storage fee.

But sometimes the storage bills go unpaid. Sometimes patients move or fail to respond to repeated attempts to contact them. Today there are an estimated 600,000 to 4 million frozen embryos stored in the United States that are abandoned or unclaimed, representing an enormous burden for clinics and storage facilities.

At a traditional storage rental facility, the customer who repeatedly failed to pay storage fees would find his belongings locked up and auctioned off or thrown out into the street. The facilities where frozen embryos are stored have no such easy recourse—ethical and legal issues abound. Reputable clinics and storage facilities go to great lengths to ensure that patient wishes are honored, making repeated attempts to contact embryo owners and often continuing to store embryos despite decades of unpaid bills rather than destroying them without permission.

There are no federal regulations or statutes governing the disposition of frozen embryos created through ART. State courts follow a patchwork of judicial and legislative remedies. Laws directly related to embryo disposition are few and often lumped in with disposition of genetic material or medical waste. In some cases, state laws governing embryos are inconsistent with other laws governing personhood, wrongful death, homicide and stem cell research.

Even California, generally progressive in regard to ART law, remains largely silent when it comes to providing a framework for attorneys and the courts to resolve questions of embryo abandonment and dissolution.

The California Health and Safety Code Section 125315 requires reproductive healthcare providers to give ART participants a consent form with options for disposition of the reproductive material upon the occurrence of certain contingencies. The California Penal Code 367g makes it a felony to use or implant sperm, eggs or embryos except as expressly provided in a signed writing by the provider of the genetic material. Taken together, these statutes arguably may suggest that control and decision-making authority over reproductive material belong to each person individually.

As in most areas of ART law, developing a set of best practices for abandoned embryo disposition is still a work in progress. The issue of abandoned embryos will continue to challenge clinics and cryopreservation facilities until the law catches up to the technology. For the time being, providers are advised to check state law to ensure consent forms are in compliance. For any use other than originally authorized by the patient, require an updated, signed consent, and be sure it is notarized to ensure the patient’s wishes are honored in the event of death or divorce. Last but not least, clinics should establish a written protocol for contacting patients and determining whether embryos are indeed abandoned. The protocol itself will serve to let patients know the consequences of failure to pay storage or loss of contact.

IVF patients and intended parents also bear a responsibility to be as informed as possible about the IVF process, to carefully consider all potential outcomes when making decisions about unused embryos, and to live up to their contractual commitments to their clinic or storage facility. Anecdotal reports indicate some owners of unused embryos cut off contact with clinics or storage facilities out of guilt: They want neither to have additional children nor to continue paying storage fees, but they don't want to make the call to have the embryos destroyed. Some assume the embryos would be destroyed as soon as they stopped making payments, apparently oblivious to the dilemma they have created for the providers. After all, reproductive health care providers, cryopreservation and storage companies, and patients all have the same goal: fewer abandoned embryos.

 

 

Richard Vaughn
rich@iflg.net

Attorney Rich Vaughn is founder and principal of International Fertility Law Group, one of the world’s largest and best-known law firms focused exclusively on assisted reproductive technology, or ART, including in vitro fertilization (IVF), surrogacy, sperm donation or egg donation. Rich is co-author of the book “Developing A Successful Assisted Reproduction Technology Law Practice,” American Bar Association Publishing, 2017.

Peiya Wang
PEIYA WANG(王培娅)
Paralegal (律师助理)

Peiya Wang joined IFLG as a paralegal in 2015, where she manages surrogacy, egg donation and parental establishment cases and provides translation services for many of IFLG’s international clients. Peiya moved to the United States in 2012 to attend Northeastern University in Boston, Massachusetts, receiving a Master of Science degree in Global Studies and International Affairs in 2014. Peiya moved to Los Angeles in 2015, received her paralegal certification from UCLA Extension, and obtained her second Master of Science degree in Legal Studies from Loyola Law School. Peiya relocated back to her hometown, Beijing, China in 2019 and works from IFLG’s Beijing office. When away from the office, Peiya is a dragon boat paddler and a ballroom dancer, where she favors Rumbas and Cha-chas. She is fluent in Mandarin and English.

Luis Sosa
LUIS SOSA
Paralegal

Luis R. Sosa joined IFLG as a paralegal in 2016, where he enjoys pursuing his passion for family and reproductive law. While working toward his bachelor’s degree at Florida International University which he received in 2013, Luis worked as a paralegal and legal assistant for family law litigation firms in Miami and Washington, D.C. As a paralegal and case manager for IFLG, Luis, who is bilingual in English and Spanish, manages surrogacy, egg donation and other reproductive law cases. Luis has worked for IFLG in both Los Angeles as well as San Francisco, and is currently based in Dallas, Texas. In addition to spending time with husband Randy and dog Marty, Luis enjoys being outdoors and appreciating the arts.

Toni Hughes
TONI BOONE
Paralegal

After receiving her B.S. in Business Management, Toni joined IFLG to pursue her dream of working in the legal field. As a Paralegal with over 10 years of experience in the assisted reproduction technology field, Toni is our Managing Paralegal, responsible for training and managing our paralegal staff. From drafting legal documents to assisting our clients with post-birth matters, Toni embraces the challenge of learning something new in this field each day. Besides spending time with her son, Jordan, Toni enjoys exploring new things, cooking, spending time with family and friends, and serving as a Youth Advisor for “Next Generation.”

Kim
KIM DEVEREAUX
Paralegal

Kim has over 30 years of experience in the legal field and has worked exclusively in surrogacy and assisted reproduction law since 1999. Kim is a senior case manager responsible for managing parental establishment cases and interacting with IFLG’s Of Counsel attorneys across the country. With three children of her own, Kim understands the importance of family and finds working in this area of law a rewarding experience.

Rich Vaughn
RICHARD B. VAUGHN
Founder

Attorney Rich Vaughn combined his personal passion as a father of twin boys born via assisted reproductive technology (ART) with more than 20 years of experience in business and technology law to build International Fertility Law Group. Today IFLG is one of the most successful and best-known law firms in the world focused exclusively on fertility law, helping thousands of intended parents through empathetic listening, compassionate guidance, and unmatched legal expertise. As an advocate for reproductive freedom, Rich also contributes his knowledge and time to improving the understanding and practice of ART law, most recently as a founder of and speaker at the first Cambridge University International Surrogacy Symposium held in June 2019, as immediate past chair of the American Bar Association ART Committee, and as a popular presenter to law schools, faculty and advocacy organizations all over the world.

Elizabeth Tamayo
ELIZABETH TAMAYO
Paralegal

Elizabeth received her Bachelors of Science degree in Criminal Justice from California State University of Los Angeles. Shortly after graduating, she continued her education at the University of California, Los Angeles where she obtained her Paralegal certificate. Elizabeth is fluent in Spanish and has been in the legal field since 2009. She is excited to be a part of the IFLG Team helping families realize their dreams.

Sunny Chien
SUNNY CHIEN
Paralegal

Sunny joined IFLG as a paralegal in 2017, where she manages surrogacy, egg donation and parental establishment cases for many of IFLG’s international clients. She holds a Bachelor of Arts degree in Philosophy from California State University of Los Angeles, where she graduated cum laude. Sunny is bilingual in English and Mandarin and has extensive experience as a legal assistant and paralegal at Los Angeles-area law firms. She is excited to be part of the IFLG team. In her spare time, Sunny enjoys spending time with her family and their dog, going to the beach, cooking, and being outdoors.

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Molly O'Brien
MOLLY O'BRIEN
Partner

Fertility law attorney Molly O’Brien began working in the field of assisted reproduction technology (ART) in 2005, at an egg donation agency and a surrogacy agency where she became familiar with all aspects of in-vitro fertilization, egg donation and the financial aspects of surrogacy. Since becoming an attorney in 2011, Molly has drafted and negotiated surrogacy, egg donation, sperm donation embryo donation agreements for hundreds of her clients all over the world.

Phoebe Sadler
PHOEBE S. SADLER
Associate

Fertility law attorney Phoebe Sadler has a background in family law and has been practicing exclusively in the area of assisted reproduction technology (ART) law since 2018.

Rubina Aslanyan
RUBINA ASLANYAN
Paralegal

Rubina has an extensive background in the legal field as a paralegal in Family Law and has worked in surrogacy and assisted reproduction law since 2012. Her area of focus is in managing and assisting clients with surrogacy, egg donation, and parental establishment cases for many of IFLG’s domestic and international clients. During her spare time, Rubina enjoys spending time with her family and dog Bella, traveling and cooking.

Alexander Espinoza
ALEXANDER ESPINOZA
Legal Assistant

Alexander joined IFLG as a legal assistant in 2019, where he manages surrogacy, egg donation and parental establishment cases. Alex is bilingual in English and Spanish and has been in the legal field for 23 years. Alex is excited to join the IFLG team and pursuing his will to help others in the reproductive law process. In his spare time he loves spending time with his family and friends, being outdoors, road trips, loves music and dancing.

Cara Stecker
CARA STECKER
Senior Paralegal

After receiving her paralegal certificate in 2005, Cara began working in assisted reproductive law. During the fifteen years Cara has worked in this field, she has gained a wide range of experience and knowledge that she uses to help better assist clients and those involved in the assisted reproductive journey. Cara’s primary roles involve managing parental establishment matters and coordination with IFLG’s Of Counsel attorney network, drafting contracts and parental establishment court documents and providing support to other team members. Cara finds great joy in being a small part of a team of caring people who help others achieve their dream of having a family. In her spare time, Cara enjoys spending time with her husband and three children, watching her children play the sports they love, and she enjoys, running, cycling and exploring the outdoors in the sun.

Stephanie Kimble
STEPHANIE KIMBLE
Paralegal

Stephanie received her BS in History and Political Thought from Concordia University Irvine in 2015 and her Paralegal Certificate from University of San Diego later that same year. She has been working as a Paralegal since 2016 in Family and Reproductive Law. She is excited to be part of International Fertility Law Group working on managing Surrogacy, Egg donation and Parental Establishment Cases.

Trish Pittman
TRISH PITTMAN
Assistant Financial Coordinator

With more than 20 years of experience in the field of accounting, Trish joined the IFLG team in 2019 as Assistant Financial Coordinator. Her client-facing focus at IFLG is to assist with all client trust accounting. Trish is the mother of two daughters and enjoys spending time teaching and learning new things from them. In her free time, she loves long walks in the park and reading suspense and mystery novels.

Katie Deaquino
KATIE DEAQUINO
Senior Paralegal

Katie is a Senior Paralegal with IFLG and has dedicated over sixteen years to the areas of surrogacy and reproductive law. She received her Paralegal Certificate from Coastline Community College and has worked with some of the top law firms in the assisted reproduction community. Katie is also a commissioned Notary Public. With IFLG, Katie manages Surrogacy, Egg Donation, and Parental Establishment cases and provides support to other IFLG team members. Katie truly enjoys helping others build their families through assisted reproduction and is thankful she has had the rewarding experience of assisting IFLG clients. Katie often spends her free time with her Husband, four young children and her bulldog “Bella”.

Elsa Jimenez
ELSA JIMENEZ
Legal Assistant

Elsa joined IFLG as a Legal Assistant in 2019, bringing more than 35 years of experience working in the legal profession (concentrating in tort and litigation matters). At IFLG she assists surrogates with their surrogacy and parental matters. The oldest of five siblings, born and raised in East Los Angeles to Mexican immigrant parents, Elsa loves “seeing the beauty of families forming” through assisted reproductive technology. She and her husband Carlos have four children and one grandson. Elsa enjoys jazz and ’80s music, being outdoors in nature, collecting teacups and tea pots, and spending time with her close-knit family.