Embryo spent 19 years on ice. Now, it's a baby.

NORFOLK

It has a science-fiction ring to it - "Baby born from embryo frozen nearly 20 years" - but there's nothing futuristic about the idea. // Fertility experts at the Jones Institute for Reproductive Medicine assisted in the very real birth of a healthy baby in May from an embryo that had been "cryopreserved" for 19 years and 7 months.

The embryo had been donated anonymously by a patient of the Jones clinic who already had a son through in vitro fertilization - a process in which an egg fertilized with sperm in the lab is transferred to the mother's womb.

The recipient, a 42-year-old infertile woman whose place of residence was not released, had the thawed embryo implanted in her womb last year and gave birth to a baby boy in May.

The boys, conceived at the same time by the same parents, were born two decades, and two families, apart. While no central agency tracks the age of embryos implanted during IVF procedures, this is believed to be the oldest documented case, the previous record being 13 years.

Neither donor nor recipient would consent to media interviews, but researchers at the institute at Eastern Virginia Medical School wrote about the case for an article in the journal Fertility and Sterility.

This case, along with other studies the scientists have done on frozen embryos, is significant in light of the number of embryos suspended in cold storage. There are 500,000 in the United States, by one estimate. The Jones Institute, where the first test-tube baby in the country was produced, has 3,500.

That's given rise to questions about their shelf life, particularly among women and girls who have harvested their eggs in hopes of having babies after treatment for life-threatening conditions such as cancer. It's also important to infertile women who have been trying for years to become pregnant. The recipient in this case had been trying to conceive for a decade.

The growing body of embryos suspended in liquid nitrogen also begs an ethical question: What happens to these leftover life forms?

In the early years of IVF, there weren't any left over because all were transferred back into the womb within days. The first pregnancy from a frozen-then-thawed embryo was in 1983. The Jones clinic began freezing embryos three years later.

The same thing happened at fertility clinics across the country as concerns about multiple births led to the practice of transferring fewer embryos into the womb and saving others for later. Storage also was more economical because couples could use embryos from one cycle for several pregnancy attempts.

Embryologist Jacob Mayer, one of the article's authors, and other EVMS researchers did a study published in 2008 that analyzed implantations of 11,000 embryos that had been frozen anywhere from 30 days to 15 years.

Earlier, smaller studies had shown contradictory results, but this larger EVMS study showed the length of storage time had no significant effect on post-thaw survival, or on pregnancies, miscarriages and births.

In the recently reported case, the couple who donated the embryo had a successful IVF transfer in 1990. They had five leftover frozen embryos. They kept them in storage for a while, then donated them anonymously in 1993.

A match was found last year. Potential recipients are matched according to race and other desired characteristics. Only two of the embryos survived the thaw and were transferred to the recipient's womb.

Mayer said more study and tracking of frozen embryo transfers is needed, but science so far shows long-term storage is a safe option: "They are in a state of suspended animation, so, theoretically, they could be in storage hundreds of years."

Bioethicist Arthur Caplan said that idea opens a Pandora's box of ethical questions. Caplan directs a center for bioethics at the University of Pennsylvania School of Medicine and has written extensively about IVF issues.

Might embryos be handed down from one generation to another? he asks. Or could there be accidental inbreeding among adopted-out embryos? What happens if "parents" of these embryos divorce or disagree about the disposition of them? What if a couple wanted to implant an embryo years past their prime parenting years?

And what if the two boys in this case, genetically brothers, want to meet someday? What are their rights?

While some clinics have clear consent forms, no federal agency or laws govern these practices, so policies are "all over the map," Caplan said, leaving courts to settle disputes. Some countries have much stricter regulation of fertility clinics. For instance, Britain has limitations on how long embryos can be stored.

People with leftover embryos can store them, give them to other couples, donate them to science or destroy them by thawing them.

Caplan said many parents struggle with what to do, troubled by the prospect of someone else rearing their children or fearing accidental pairings of people who are biologically related.

Others have moral concerns about the idea of discarding them.

Bree and Joe Ruzzi of Virginia Beach are well acquainted with the angst.

Bree, who's now 36, was diagnosed with breast cancer in 2004. She had her eggs harvested and fertilized with Joe's sperm at the New Hope Center for Reproductive Medicine in Virginia Beach in February 2005 before having cancer treatment that could have damaged her eggs. A surrogate mother gave birth to the couple's twin boy and girl in April 2008.

The couple is overjoyed with the twins, who are now 2. But they also still have four embryos that have been frozen for six years. They're in a facility that specializes in storing embryos.

"It's a difficult, difficult situation," said Joe Ruzzi, who is 38. "We go over it and over it and over it. It's a big ordeal. We've talked about donating them, but that's difficult because they're genetically ours, and we wouldn't have a part in raising them if we did that."

A study released in 2008 by researchers at Duke University Medical Center surveyed 1,000 fertility patients and found that 53 percent did not want to donate their embryos to other couples, mainly because they felt a responsibility toward the embryos and didn't like the idea of someone else rearing their children. Forty-three percent did not want them discarded. Twenty percent were likely to keep them frozen indefinitely.

At the Jones clinic, consent forms and policies are explicit, Mayer said, and are reviewed when annual storage fees are paid. The great majority of stored embryos - some 90 percent - belong to couples who expect to use the embryos themselves. And when you consider most patients are in their 30s and 40s, few would want to wait decades before using them.

"It's hard to imagine we'd keep them hundreds of years," Mayer said. "In theory, it could be done, but I don't know why anyone would want to do it."

Elizabeth Simpson, (757) 446-2635, elizabeth.simpson@pilotonline.com