In this review article in the American Journal of Obstetrics and Gynecology, the authors Dr. Klitzman and Dr. Sauer review the ethical challenges associated with creating and selling embryos.

  1. They mention questions regarding the rights of the unborn children and their ability to know their biological parents. Companies that create human embryos de novo may wish to keep gamete providers anonymous. Many of these offspring thus will never learn that their parents are not their biologic parents.
  2. Questions surface regarding the fees that providers should charge for embryos and whether these amounts should vary based on the traits of 1 or both of the gamete donors. Some prospective parents may seek specific traits in a baby (eg, height or eye/hair coloring), which prompts the creation of embryos from 2 gamete donors who possess these characteristics.
  3. Ownership of embryos created without an advanced directive by patients poses dilemmas (eg, disposition of any remaining embryos).
  4. Guidelines do not yet exist to limit the number of embryos sold from each pair of gamete donors. Hence, unbeknownst to each other, full siblings could potentially meet, get married, and procreate.

The discussion by Drs. Klitzman and Sauer have several critical implications for future practice and professional education and policy.

  • Patients with diseases associated with genetic tests may well ask obstetricians, gynecologists, and other physicians about these techniques and practices.
  • Clinicians can refer such patients to assisted reproductive technology specialists; however, familiarity with the basic aspects of the issues and complexities involved could aid these providers and their patients Several of these issues can be addressed relatively easily through guidelines from professional associations (eg, limiting the number of embryos sold from each pair of gamete donors).

Because creation and sales of embryos will likely spread, consideration of appropriate responses is critical to establish standards