What to do with the surplus cryopreserved embryos? The view in accordance with the principles of bioethics

Diana Mihai (RO), diana comandasu (RO), elvira bratila (RO), andreea veliscu carp (RO)

[Mihai] “Panait Sârbu” Clinical Obstetrics Gynaecology Hospital, Bucharest (ROMANIA), [comandasu] Clinical Hospital of Obstetrics and Gynecology “Prof. Dr. Panait Sârbu”, Bucharest Romania, [bratila] „Carol Davila” University of Medicine and Pharmacy„Carol Davila” University of Medicine and Pharmacy ,Clinical Hospital of Obstetrics and Gynecology “Prof. Dr. Panait Sârbu”, Bucharest Romania, [veliscu carp] „Carol Davila” University of Medicine and Pharmacy„Carol Davila” University of Medicine and Pharmacy ,Clinical Hospital of Obstetrics and Gynecology “Prof. Dr. Panait Sârbu”, Bucharest Romania

CONTEXT.The assisted reproduction technologies (ART) have given millions of infertile couples worldwide hope to accomplish their dream: having children. The ethical major issues arise when deciding what will happen with the surplus embryos, that have remained cryopreserved. While the accurate number of frozen embryos is unknown, in 2013, for example, it was estimated that there were more than 1.400.000 only in the US. OBJECTIVES.The purpose of this paper is to survey the major ethical issues regarding the future of the cryopreserved embryos, as many individuals often over-look questions regarding “left-over” embryos, that raises more and more controversy worldwide.METHODS.This paper is a complex review of the literature, we present and synthesize the different medical options for the cryopreserved embryos from the specialty worldwide literature, while having as a background for each option the bioethics principles, the worldwide legislation available in the ART field and the point of view of the religious associations.RESULTS and CONCLUSIONS.This is a very sensitive subject, as the embryo, as we demonstrate, is not considered as a full-righted person, but it is entitled to greater respect than any other transplanted tissue for its biological potential.The options of the couple are: disposing of the embryos by thawing them or engage in compassionate transfer, donate them for other couples or give them for “adoption”, otherwise donate them for research. Some couples simply “abandon” the embryos. While discussing these options, we take into account the principles of bioethics: respect for autonomy, non-maleficence, beneficence, and justice.There are specific laws that must be known by the doctors involved, laws stipulated by the Societies of Human Reproduction and Embryology, by the Declaration of Human Rights and by different Civil and Penal Codes available, that differ from country and state worldwide, that ballance respect both for the “parents” and for the embryo.The Christian Religion beliefs are not very permissive about this field, while the medical researchers emphasize on the tremendous potential the embryo stem cells have on curing disease such as cancer, genetic disorders and infertility.