For the Least of These

Her name is Grace. She's very cute, and her parents love her very much — both sets of them.

Grace is a special girl. The woman she lives with in Southern California, Elizabeth, is her legal and biological mother. Elizabeth is not, however, her genetic mother. Grace's genetic mom lives in the Midwest.

Grace's story is one of God's love, providence and, well ... grace. It is also, however, a cautionary tale of what can happen when medicine and science outrun moral reasoning.

A moral dilemma

Grace began life as all humans do, as an embryo. But Grace was created outside the womb in a process called in vitro fertilization — she's a "test-tube" baby. The sperm and egg of a husband and wife were brought together in a laboratory, where Grace was conceived. In fact, more than 20 other eggs were fertilized at that time. That married couple in the Midwest was undergoing fertility treatment; several of the fertilized eggs were transplanted back into the mother's womb, and she later gave birth.

The remaining embryos were frozen in tanks of liquid nitrogen. After the mother gave birth, the university hospital where the remaining embryos were stored asked the parents what they would like to do with them. And then the realization hit. Any one of those frozen embryos could have been their newborn child. They were in fact the child's brothers and sisters, since they were biologically human and created from the same batch of sperm and eggs.

That family faced a dilemma. What to do with the remaining embryos? Destroying them was out of the question.

Waiting on God

Switch to Southern California. Elizabeth and her husband, Zach*, had been trying for many years to conceive children and had undergone fertility treatments of many kinds. Finally, they were called into their doctor's office in January 1997. The call sounded serious.

"I was waiting for him to tell me I had cancer," Elizabeth says. The news, as far as Elizabeth was concerned, was worse. They could never have children. "I was so devastated, I thought it would have been better if he'd told me I had cancer," she recalls. "I couldn't believe I was never going to feel a baby kick inside me. It goes beyond just wanting a child."

Their doctor proposed in vitro fertilization, but it would have to be with a donated egg. "I wasn't too sure about that," Elizabeth says. Her church denomination believed that in vitro fertilization was ethical only if the sperm and egg came from a married couple.

Months passed. Elizabeth and Zach in the meantime went through the full background check, a "home study," required to legally adopt in California. Elizabeth made this entry in her journal on Nov. 19, 1997: "I've been praying that God would take this desire [to have a baby] away from me if He doesn't want it to work out."

Shortly after that journal entry, Elizabeth and Zach attended a Christmas play with Ron Stoddart, a lawyer friend who worked for Christian Adoption and Family Services in Brea, Calif. One line in that play struck both Elizabeth and Ron.

"In the intricate design of each flake of snow we find the Creator reflecting the uniqueness of the individual person." Snowflake. Frozen embryo!

If Elizabeth and Zach used a frozen embryo, they would not violate the husband/wife bond, Elizabeth would be able to experience pregnancy and childbirth, and a child being held in a "frozen orphanage," as Ron calls it, would have a chance at life.

But Elizabeth and Zach insisted that if they were to go forward with the procedure, the embryo would have to be legally adopted as any other child would be, and it would have to be an open adoption, meaning the child would know who her genetic family was and would remain in contact with them in some form.

No coincidences

Elizabeth and Zach had been in touch with Focus on the Family and had met Sydna Massé, then the head of Focus' Crisis Pregnancy Ministries. They told her about their idea of adopting a frozen embryo.

Sydna recalls having lunch with Elizabeth and Zach, after which she gave them a handmade afghan blanket, which had been donated to Focus to give to "a special child."

"I know God is going to give you a child," Sydna told them, "so I want to be the first to present you with a baby gift."

Unknown to any of the three, the family in the Midwest had been in touch with counselors at Focus on the Family. One later approached Sydna with a real stumper: He knew a mother in the Midwest who had 20 frozen embryos she wanted to place for adoption.

Sydna was excited. "I have just the referral for you!" she said.

A miracle

The two couples were introduced and arrangements were made to send the embryos to California. Elizabeth spoke on the phone with the genetic mother on New Year's Day, 1998.

"I was nervous for maybe the first second," Elizabeth recalls, "and then we just hit it off. As we've gotten to know each other, we just find more and more similarities with each other."

Twenty frozen embryos were shipped to California. The doctor first chose 12 of the 20 to thaw. Only three survived the thawing process, and they were transferred to Elizabeth's womb in March 1998. None implanted in the wall of the uterus; Elizabeth was not pregnant.

Only eight embryos remained. They would try again Easter weekend. Only three of the eight survived that thawing, and they too were transferred into Elizabeth.

"Easter weekend is when we celebrate new life," Elizabeth says. "Grace came back to life that weekend when she was transferred into me."

The rest of the story

Grace was born Dec. 31, 1998. As she grows she'll get to know her genetic siblings in the Midwest. And for her genetic parents, there is also a form of God's forgiveness. If Elizabeth had gotten pregnant on the first try, they might still have frozen children waiting to be born. But in God's sovereignty, all of the 20 remaining embryos were used, and He chose one to create Grace.

"We didn't set out to be crusaders," Zach says. "We just wanted a baby. But if you said we could go back and have our own genetic kids but not have Grace, we'd say no way."

On the Medical and Legal Frontier

As medicine and science delve ever deeper into solving problems of infertility, they have raced ahead of both legal and ethical thinking on the subject.

For example, while no one knows exactly how many frozen embryos are in storage in North America, some estimate there to be as many as 100,000 human embryos held in cryogenic banks. One concrete number to consider: In 1996, the last year for which complete records are available, doctors conducted 8,661 transfers of frozen embryos, using an average of 3.5 embryos per transfer, according to the American Society for Reproductive Medicine. But doctors frequently fertilize as many as 30 eggs at a time during in vitro procedures. The remaining 20-plus embryos are then either destroyed or, more frequently, frozen. According to many doctors, theologians and medical ethicists, those frozen embryos are fully human.

Many considerations

One thing many doctors do not think about is the emotional impact on parents when they learn they have frozen embryos remaining, according to Dr. Joe McIlhaney, an ob/gyn and founder of the Medical Institute for Sexual Health in Austin, Texas.

"Most [fertility] programs don't even discuss this with patients," he says. "That patient gets pregnant and then realizes any one of those other embryos could have been this baby." That realization, he says, hits hard. "There's a sense of desperation, a sense of guilt that they didn't investigate this more."

McIlhaney says that patients considering in vitro fertilization must clearly state their beliefs before the doctor ever begins. "First, it's not necessary to fertilize so many eggs," he says. "To plan not to transfer all embryos back to the mother or to plan to kill them shows great disdain for what those embryos are."

McIlhaney says couples should state they don't want a single embryo destroyed unless medically it is incompatible with life. (Such embryos usually miscarry spontaneously.) "The doctor should fertilize only the number of eggs that will be put back in the woman's body during the present cycle or in future cycles," he says. Generally, no more than two or three embryos should be transferred each time.

From a legal standpoint, both the genetic parents and the receiving couple must do their homework, according to Ron Stoddart of Christian Adoption and Family Services in Brea, Calif. Stoddart founded the Snowflakes Embryo Adoption Program in response to the growing controversy over what to do with frozen embryos.

"If we believe the embryos are preborn babies and are entitled to the same legal protection as a born child, then an [adoption] home study is in order," he says. This also gives the genetic parents greater control over where the embryos are placed.

For the receiving family, Stoddart cautions, "Don't live in a fantasy. You must tell the child he's adopted. With a frozen embryo, it's tempting not to tell him because you carried him and gave birth to him."

This is true even if the adoption is "closed," that is, neither set of parents knows the other. In such cases, it is especially important to work with a reputable agency. The agency will know the medical background of the genetic parents. "Whatever you do," he warns, "do not buy a frozen embryo, and do not work through 'facilitators' or search [for donors] using the Internet.

"Be sure to get something in writing from the genetic parents to transfer the embryos, sort of like 'transferring title,' " Stoddart says.

Stoddart sees an additional opportunity arising from the legal and medical conundrum, however.

"Right now the law is way behind in areas of reproductive technologies," he says. No state fully recognizes a frozen embryo as a human being, although Stoddart says some case law is developing in that direction. And as more case law develops, this provides more legal protection for the unborn with regard to abortion.

"The danger legislators see is if they give embryos the same rights as a person, this conflicts with their abortion statutes," he says. "But we want to give any unborn embryo the same rights as a baby."

* Name withheld.

To contact Christian Adoption and Family Services or to learn more about the Snowflakes Embryo Adoption Program, write 1698 Greenbriar Lane, Suite 219, Brea, CA 92821. Call (714) 529-2949 or e-mail info@snowflakes.org.