An Embryologist’s Post-Conversion Reflection
When Laura Elm, the Director and Founder of Sacred Heart Guardians and Shelter, asked me to write something about embryo viability as it relates to the discarding of human embryos, I was at first reluctant. Perhaps that is because it is digging up an unpleasant memory, or it requires deep thought and reflection that is sometimes difficult to do.
For context, after training for 9 years to be a reproductive physiologist, I became an embryologist and laboratory director for a human assisted reproductive technology laboratory. I conducted all the modern technical procedures related to IVF and I discarded many “non-viable” embryos into the medical waste. I can remember always instinctively pausing each time my hand was over the biohazard disposal container, as if to double-check that I was, in fact, discarding the correct embryos. Maybe it was also something else that caused me to pause.
The conversion that led me away from the field took over 7 years. Part of that conversion was because of the realization that IVF was a disordered approach. But it was also because of a deeper knowledge leading a person to realize that they know much less than they thought they did. For example, an embryologist is trained to identify the quality of an embryo. In theory, a higher quality embryo is more likely to result in a live birth than a low-quality embryo.
Except that there are plenty of examples of cases that should have resulted in pregnancy and didn’t. Even more surprisingly, there are examples of embryos that by all conventional measures should never have resulted in a baby, and yet they did. These types of embryos were only transferred back to the woman because they were the only ones available and if they had been subjected to selection by a trained eye, they would have been discarded.
To rectify this discrepancy in our ability to accurately determine embryo viability, the IVF field has developed extremely sophisticated methods to try to determine which embryos should be given the chance to develop. They use a procedure called preimplantation genetic diagnosis which requires microsurgery to remove one or more cells from the embryo and then analyze chromosome content or a specific gene of interest. It was believed that this powerful technology was a precise way to select viable from non-viable.
Except newer information is now indicating that the pre-implantation diagnosis procedure results in discarding embryos that could have developed normally.
Despite having some cells that are abnormal, an early embryo has the capacity to “self-correct.” It does this by selectively pushing the abnormal cells out and replicating the normal cells. In fact, it appears that the abnormal cells become part of the placenta, leaving the normal cells to become the fetus. This is a remarkable biological process that is somehow “programmed” into these primitive cells.
To me this revelation reinforces the meaning of the Psalmist’s words:
“For you formed my inward parts; you knitted me together in my mother’s womb. I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well. My frame was not hidden from you, when I was being made in secret, intricately woven in the depths of the earth.” Psalm 139:13-15
Because IVF is a disordered approach, it creates the problem of thousands of embryos discarded, frozen and experimented on while attempting to solve the problem of infertility. But once already formed, maybe we should not be focused so much on judging viable from nonviable. Maybe we should be focused on what else we can do to support continued development for every one of them. Then when despite our efforts, these fragile early human lives end, maybe we should cherish, respect, and give them the dignity all human persons deserve.
Dr. Craig Turczynski is a Reproductive Physiologist, Certified Teacher of the Billings Ovulation Method®, Director of Strategy and Scientific Affairs for BOMA-USA, and currently serves on the board of advisors for Sacred Heart Guardians and Shelter.