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Tragically Losing Thousands of Human Embryos in Two Very Different Ways

Tragically Losing Thousands of Human Embryos in Two Very Different Ways

Continued promotion of PGT-A/PGS still lead to loss of many healthy human embryos, even with incontrovertible evidence against its value

It happened barely a few months ago on March 3 and 4 on both sides of the country, eerily on the same days: Cryopreservation tanks at two highly reputable major IVF centers malfunctioned, leading to the unrecognized thawing of, likely, thousands of embryos. By the time the damage was noted, most, if not all, of these thawed embryos had lost viability.

The VOICE recently addressed these tragic events in an attempt to reassure CHR’s patients that everything possible is being done by CHR (and we assume most other IVF centers) to prevent such malfunctions from going unrecognized. What made these two occurrences so damaging, was not the malfunctioning equipment itself but the failure of both institutions to recognize in timely fashion that their storage tanks were, indeed, malfunctioning. If noticed early, there would have been ample time to refill liquid nitrogen in those tanks even manually until damaged equipment could be replaced.

Considering the potential legal consequences of these two tragic events, it is not surprising that so little has been said in public about what transpired, what the quantity of damages was and how the centers have been handling the situation. That the latter cannot be easy, appears obvious since cryotanks in IVF centers contain the reproductive expectations and life dreams of patients in the form of cryopreserved embryos, eggs, semen and/or ovarian tissue. To suddenly face the reality that all of this is gone, must be truly devastating!

The possibility of such an event is, of course, the nightmare of every IVF center, and we have rarely before seen as much chatter and soul searching from within the IVF community. These events, however, also raised additional concerns among members of the lay public, as Julie Washington pointed out in a piece in The Plain Dealer on April 11 called, “Are frozen embryos human life? Fertility treatments present ethical dilemmas.”

The issue of whether human embryos are “human life” or not has, of course, remained controversial. Most biologist do not see human embryos as already representing “human life;” yet, almost everybody in the field, of course, agrees that human embryos are deserving of special deference. Howard Jones, Jr., widely considered America’s “father of IVF,” who in 2015 died at the age of 104 years, coined the term “pre-embryo” for embryos prior to implantation, wanting to make the point that an embryo is not a “real” embryo until it implants. He also always pointed out that, even during natural conception, a large majority of human embryos never implant and never have a chance of pregnancy and, therefore, future life.

Some religions, however, disagree, and consider different stages of embryonic development as starting points of human life. Even though most human embryos, whether in vivo (in the body) or in vitro (i.e., IVF lab) never implant, the Catholic church and other religions consider fertilization as the beginning of “human life.” Other religions consider human life to start with fetal heart or even with delivery. The law in this country also does not recognize human embryos before implantation as “human life.” Yet, it is interesting that, as Washington noted in her article, above noted massive embryo losses invigorated this debate.

Even more interesting to us here at CHR, however, is the obvious discrepancy in how the IVF field and most of the lay public (media included) view large volume human embryo loss in IVF differently, depending on what caused the embryo loss.

When two freezing units malfunctioned and hundreds to thousands of embryos were lost, likely every single IVF center in the country reaffirmed its commitments to the prevention of such tragic embryo losses. Yet, when increasing evidence (by now beyond reasonable doubt) established that preimplantation genetic testing for aneuploidy (PGT-A), previously called preimplantation genetic screening (PGS), worldwide led to the disposal of tens, if not hundreds, of thousands of perfectly normal human embryos and, even with currently in use methodologies, still, produces ca. 40% false-positive diagnoses (Paulson RJ. Preimplantation genetic screening: what is the clinical efficiency? Fertil Steril 2017;108(2):228-230), the continuous utilization of PGT-A in IVF practice is difficult to understand. One really wonders where the special dignity human embryos by wide-held consensus are deserving, is expressed by an IVF community that is continuing to offer PGT-A to patients.

This is a part of the May 2018 CHR VOICE.

Norbert Gleicher, MD

Norbert Gleicher, MD, FACOG, FACS

Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.

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