Abandoned frozen embryos in Argentina: a committee opinion

[Some present and future ethical dilemmas surrounding advancements in in vitro fertilization.]

The growing field of assisted human reproduction has achieved unimaginable milestones. Its continuous development and the innovations it generates at times pose both ethical and legal dilemmas. This essay aims to elucidate the progressive changes occurring in the realm of the origin of life due to the development of new options and strategies in assisted human reproduction. First, it constructs an interdisciplinary reflection on human nature and the changes society faces from the perspectives of science, ethics, and law, particularly from the perspective of Spain. Second, it provides a brief overview of current or future biomedical techniques in the field of human reproduction. It concludes with a discussion of the need to reflect on the rapid advancement of science in assisted human reproduction.

Final destination of surplus cryopreserved embryos. What decision should be made?

Objective:

The aim of this study was to evaluate what data exists in the literature about the fate of SCE.

Methods:

This is an integrative review of papers published in the last ten years, in the Medline and PubMed databases on the subject.

Results:

the studies included in this review demonstrate that the difficulties in defining the fate of surplus cryopreserved embryos are mainly due to the absence of specific legislation in most countries. Sociocultural and demographic factors such as religion, treatment period, ethnicity, income, marital status, economic status and education level are factors that influence the choice of the final destination of ECE. This study demonstrated that in most of the countries evaluated, the law or regulations do not provide clear guidance on the final destination of the surplus cryopreserved embryos, although it is reasonable to consider that the law will treat embryos, after a certain period of time, as abandoned. Accurate information about the desired destination of the surplus cryopreserved embryos is needed from the beginning of the breeding process to minimize future problems.

Conclusions:

We conclude that this is a controversial issue, involving ethical, legal, moral and financial issues, that lack specific legislation in almost all of the countries evaluated, which contributes to indecision, abandonment, and it hinders the final destination of these embryos.

Evaluation of the effect of the elective blastocyst-stage embryo transfer and freezing strategy on the abandonment of frozen embryos under the Taiwan National Assisted Reproduction Act

Purpose

To evaluate the relationship between elective blastocyst transfer, freezing strategy, and the abandonment of frozen embryos with a storage time limit of 10 years as specified in the National Assisted Reproduction Act of Taiwan.

Methods

This two-phase retrospective cohort study was conducted at a single tertiary center, Kaohsiung Chang Gung Memorial Hospital (KCGMH), in 2019. Participants were selected from a data registry containing 4167 fresh IVF cycles, including phase 1 cycles from 1999 to 2009 and phase 2 cycles from 2010 to 2014, at KCGMH.

Results

In phase 1, embryo abandonment was associated with the production of more mature oocytes and embryos, the freezing of more embryos, young female age, blastocyst transfer, and positive pregnancy results. After adjustment for confounding factors, only positive pregnancy results (adjusted odds ratio [aOR] 4.38, 95% confidence interval [CI] 3.17, 6.04), the freezing of ≥ 2 embryos (aOR 3.68, 95% CI 3.10, 4.38), the production of ≥ 6 embryos (aOR 1.68, 95% CI 1.03, 2.73), and the use blastocyst transfer (aOR 2.46, 95% CI 1.64, 3.69) remained significantly associated with embryo abandonment. The factors associated with embryo abandonment or possible abandonment were similar in phase 2.

Conclusion

For elective blastocyst stage transfer and a freezing strategy performed according to the Taiwan National Assisted Reproduction Act, a young female age ≤ 35 with positive pregnancy status due to the original IVF treatment, the production of ≥ 6 embryos, and the cryopreservation of ≥ 2 blastocysts may increase the likelihood of abandoning embryos in the future.