In the cutthroat field of fertility treatments, Dr.
Ernest Zeringue sharply cuts costs by creating a single batch of embryos, then
divvying it up among several patients. One 'horrified' critic calls it the
'commodification of children.' Dr. Ernest Zeringue was looking for a niche in
the cutthroat industry of fertility treatments. He seized on price, a huge
obstacle for many patients, and in late 2010 began advertising a deal at his
Davis, Calif., clinic unheard of anywhere else: Pregnancy for $9,800 or your money back.
Amy Hobgood feeds her twin daughters Adrienne, left, and Laura at their home outside Boston. Hobgood, 41, had spent eight years trying to become pregnant; the strain on her marriage led to divorce. She turned to Dr. Ernest Zeringue's clinic in Davis, Calif., after she was single, drawn by the price and the prospect of pristine embryos. She and her former husband are now getting back together. (Dominic Chavez, For The Times / October 29, 2012)
That's about half the price for in vitro fertilization at many other clinics, which do not include money-back
guarantees. Typically, insurance coverage is limited and patients pay again and
again until they give birth — or give up. Those patients use their own eggs and
sperm — or carefully select donors when necessary — and the two are combined in
a petri dish to create a batch of embryos. Usually one or two are then
transferred to the womb. Any embryos left over are the property of the
customers.
Zeringue sharply cuts costs by creating a single batch
of embryos from one egg donor and one sperm donor, then divvying it up among
several patients. The clinic, not the customer, controls the embryos, typically
making babies for three or four patients while paying just once for the donors
and the laboratory work. People buying this option from Zeringue must accept
concessions: They have no genetic connection to their children, and those
children will probably have full biological siblings born to other parents.
Inside the industry, Zeringue's strategy for making
embryos on the cheap has spurred debate about the ethical boundaries of
creating life. "I am horrified by the thought of this," said Andrew
Vorzimer, a Los Angeles fertility lawyer alarmed that a company — not would-be
parents — controls embryos. "It is nothing short of the commodification of
children." Other experts say they see no problem with the arrangement,
although the business model and the issues it raises are to be discussed at a
meeting in January of the ethics committee of the American Society for
Reproductive Medicine. Zeringue said the concerns are overblown. Most of his
customers have run out of money and patience by the time they come to his
clinic, he said: "They're kind of at the end of the line."
::
Natosha Dukart and her husband, Brad, an oil field
worker, spent more than $100,000 without producing a child. They ran up credit
cards, flipped houses and moved four times to help finance round after round of
IVF. It was never clear if the problem was her eggs or his sperm. After eight
unsuccessful attempts, Natosha took to the Internet and found Zeringue's
clinic, California IVF: Davis Fertility Center Inc., and its embryo program,
California Conceptions. With no financial risk, there was nothing to lose. "It
was an easy choice," Natosha said.
She sent their photographs to the clinic and filled
out a form saying they wanted a Caucasian baby. Two months later, they received
a profile of an embryo the clinic had frozen in storage. Both donors had brown
eyes and healthy family histories. The Dukarts liked the description and this
February traveled from their home near Calgary to Davis in an attempt to get
Natosha pregnant. "It was just as emotional as it was with our own
embryos," she said. Last month, at age 39, she gave birth to a healthy
7-pound girl with blue eyes and dark hair. The couple named her Milauna. "She
is absolutely perfect," Natosha said. Natosha, who was adopted at birth,
said adoption was their backup plan. But finding a child, especially a healthy
infant, can take years and cost far more than $9,800 in lawyer and agency fees.
Another option is known as embryo donation. There are
more than 500,000 frozen embryos left over from IVF procedures in the U.S. Most
patients leave their embryos in storage or destroy them. A small number —
perhaps a few hundred a year — donate them to other couples trying to have
children. But the waiting lists can be long, and there is no guarantee that the
embryos will work. Most were created from the eggs and sperm of couples with
fertility problems.
In contrast, the eggs and sperm used in the Davis
program come from young healthy donors, raising the chances that the embryos
will be viable. The clinic gives patients three attempts to become pregnant
within a year — each time using embryos from a different batch. Most women
under 55 are eligible for the guarantee. Nearly 200 patients have used the
program so far, and the clinic said that 95% of them had a successful pregnancy
— and about half of them wound up with twins. The clinic, which employs several doctors, still does traditional IVF. But
Zeringue said growth is being driven by the embryo program. By next year (2013), with an expansion of his
laboratory, he expects the program to enroll up to 40 patients a month. He
recently raised the fee to $12,500 — still a bargain, he said.
::
Before the clinic makes a batch of embryos, it sends
an extensive profile of a sperm donor and an egg donor to prospective parents. Once
the clinic gets buy-in from a few patients, it purchases the sperm from a sperm
bank, harvests eggs from the egg donor and combines them in the laboratory. A
single pairing can result in a dozen embryos, and the clinic keeps the extras
frozen while it looks for patients who want them. "We want to keep the
embryos moving," Zeringue said. "The goal is not to create a
bank."
The clinic usually has a supply of about 10 unclaimed
embryos available, he said. "While we do our best to match your stated
preferences, our primary goal is to help you attain a successful
pregnancy," the clinic informed Amy Hobgood in its standard email
accompanying embryo profiles sent to patients. The first profile Hobgood
accepted fell through. Because of a problem with the egg donor, the embryos
were never made. She finally agreed to accept stored embryos that had been
created with sperm from a 6-foot-5 college student and eggs from a music
graduate who — like Hobgood — was 5 feet 8 with green eyes. Two other women
were already pregnant from the same batch.
Hobgood, who lives outside Boston, had spent eight
years trying to get pregnant. She had become so depressed that she didn't feel
like living, she said, and the strain on her marriage led to divorce. She
turned to the Davis clinic after she was single, drawn by the price, the
prospect of pristine embryos and the knowledge she would not have to deal with
any that were left over.
In February, Hobgood, 41, gave birth to twin girls,
Laura and Adrienne. She and her ex-husband are now getting back together. When
she sees childless couples looking at her girls, she feels the urge to share
her story. "They don't realize the joy you can have with today's technology,"
she said.
::
Has the Davis clinic gone too far? Dr. Robert
Klitzman, a bioethicist at Columbia University, was among several experts who expressed serious reservations
about the program, saying it essentially amounted to creating embryos for sale.
"It gets kind of creepy," he said. "There is a yuck factor. We
need to proceed very carefully." For some people in the field, the ethical
considerations come down to informed consent. "As long as people
understand what they're getting into, I don't think there's anything wrong with
it," said Dr. James Grifo, head of the New York University Fertility Center. "It costs a lot of money to do
IVF."
Zeringue said donors and recipients are properly
informed. Patients interviewed by The Times said they understood what they were
getting into. Frozen embryos owned by the clinic, Zeringue said, "are
still treated ethically. They are no different than embryos that have a
person's name assigned to them." As for concerns that biological siblings
could unwittingly meet someday and mix their genes, Zeringue said the chances
are remote because patients are scattered geographically.
Source: LA Times
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