The freezing of sperm, eggs and embryos is increasingly a common practice in fertility clinics across the United States and indeed across the world. All such procedures involve freezing in liquid nitrogen. As Pam Belluck of the New York Times reports, a change in freezing technology in recent years has made things easier. The previous technique, ?slow freezing,? could create ice crystals, which could damage eggs when they were thawed. But several years ago, clinics began using a process called Vitrification, in which the temperature of the eggs in the liquid nitrogen is dropped so quickly that they are frozen ?truly in a matter of a second.? Clinics with experience in thawing eggs normally work with donor eggs from young women in their 20s. Such eggs are more likely to thaw without damage, and are more likely to produce healthy pregnancies and babies. After the egg is thawed, it is fertilized with sperm using a process called intracytoplasmic sperm injection (ICSI). Dr. Janis Fox, assistant professor of reproductive endocrinology at Harvard, details that an egg must be fertilized, grown into an embryo for about five days, screened for genetic abnormalities and then implanted in the womb and carried to term. The odds of success at each step are far below 100%. Dr. Fox and Dr. Randi Goldman, a clinical instructor of reproductive endocrinology and infertility at Harvard, predict that a 36-year old woman who freezes 10 eggs has a 60% chance of at least one live birth. A 2016 study by researchers in Spain, which involved 137 women whose frozen eggs were thawed, was less optimistic, predicting that women 36 and older who freeze 10 eggs have a 29.7% chance of giving birth.

How widespread is egg freezing? It is up from 475 in 2009 to 6,207 women in 2015, according to data from the Society of Assisted Reproductive Technology. Over 20,000 American women have had their eggs frozen, but the vast majority (about 85% or more) have not had their eggs thawed. As Belluck reports, ?. . . there are not enough cases to evaluate and come up with solid data on the odds of success. It also means that many clinics that freeze eggs do not have experience thawing them. Eggs are trickier to thaw successfully than embryos, experts said. An egg is one cell, the largest cell in the body, and contains a lot of fluid and a structure called a spindle, which helps organize the chromosomes. A five-day old embryo is the same size, but contains more than 100 cells, each of which is less vulnerable to damage.?

All of the technology summarized above demonstrates the truly incredible strides that have been made in reproductive technologies. But, the dangers associated with these technologies are real and they indicate the slippery ethical boundaries that are now being tested. For example, in early March a long-established San Francisco fertility clinic (the Pacific Fertility Clinic) experienced a liquid nitrogen failure in a storage tank holding thousands of frozen eggs

and embryos for future use, jeopardizing ?tissue hundreds of women had stored in hopes of having children.? A similar malfunction had occurred the same weekend at an unrelated clinic in Cleveland, the University Hospitals Fertility Clinic. As Amy Goldstein of the Washington Post reports, ?such large-scale incidents appear to be unprecedented.? Apparently, the level of liquid nitrogen in one of the San Francisco clinic?s steel storage tanks had fallen too low. ?Too little liquid nitrogen causes the temperature in the waist-high tanks to rise, risking damage to tissue housed in vials called cryolocks. Each vial can contain as many as three eggs; embryos?fertilized eggs?are stored individually.? The clinic has not reported on the exact number of eggs and embryos affected, but storage tank 4 ?contained several thousand? eggs and embryos. The Pacific Fertility clinic has begun calling the over 400 patients who had eggs or embryos stored in tank 4. Some of the eggs and embryos stored in tank 4 had been there for as long as 10 years. The fees at Pacific Fertility clinic for egg-freezing start at $8,345 for an initial cycle and $6,995 for subsequent rounds. ?In each cycle, a patient?s ovaries are simulated with drugs to produce multiple eggs, which are then harvested by doctors and frozen.? In the Cleveland clinic incident, about 700 patients may have had their eggs or embryos damaged.

How many such fertility clinics are there in the US? Pam Belluck reports that there are about 400 to 500 fertility clinics in the US. Both the Cleveland and San Francisco clinics are ?large, reputable, subject to oversight? and both quickly acknowledged their failures. However, there are many private clinics that have no affiliation with a university or hospital and are not accredited by either the Joint Commission of Healthcare Organizations or the College of American Pathologists, which inspects clinics regularly.

A final development of some interest in reproductive technology is an occurrence in Brazil. As Samantha Pearson of the Wall Street Journal reports, over the past 7 years, human semen imports from the US to Brazil have surged as more rich single women and lesbian couples select donors whose online profiles suggest they would yield light-complexioned and preferably blue-eyed children. Brazil has become one of the fastest growing markets for imported semen. Last year over 500 tubes of frozen semen in liquid nitrogen were shipped to Brazil, up from 16 in 2011. ?The preference for white donors reflects a persistent preoccupation with race in a country where class and skin color correlate with glaring accuracy.? In 2016, heterosexual couples bought 41% of Brazil?s imported semen, single women purchased 38% and lesbian couples bought 21%, with demand growing in the last two groups.

How should we think biblically about all of these procedures? Several conclusions:

1. Freezing sperm and eggs does not jeopardize the life of a human being, because before fertilization there is no human being.
2. However, embryo freezing is problematic if, as is most likely the case, in vitro fertilization (IVF) was used to produce the embryo in the first place. Normally, IVF involves multiple fertilizations and thereby multiple embryos, with those not implanted in the womb being destroyed or frozen. What happens to the remaining embryos that are not implanted or frozen is an ethical problem. Psalm 139:16 makes it quite clear that God values even embryonic life.
3. Embryonic life must be protected. Since the embryo is a person in God?s eyes, the embryo has the right to protection from harm. For that reason, the recent developments at the San Francisco and Cleveland clinic are ethically very serious. Human life was not protected at those clinics?but harmed!
4. Although there is not reliable data yet available, it seems reasonable to conclude that frozen embryos will likely deteriorate over time so that they will not survive implantation. Today, success rates with frozen embryos are lower than successes with fresh embryos.
5. Permitting women, as the Brazil story illustrates, to be rigorously selective in the sperm they choose to ensure that they have a ?white child? is getting close to the ugly specter of eugenics.

Freezing embryos is ethically problematic and, as the two tragedies at the San Francisco and Cleveland clinics indicate, a serious breach of the value assigned to the embryo by God.

See Amy Goldstein in the Washington Post (11 March 2018); Pam Belluck in the New York Times (15 March 2018); Samantha Pearson in the Wall Street Journal (23 March 2018); and John and Paul Feinberg, Ethics for a Brave New World, pp. 428-32 PRINT PDF