Parents adopt an embryo as an alternative to the difficulty of getting pregnant

After six unsuccessful attempts to get pregnant through assisted reproduction techniques, physiotherapist Maya*, 36, thought about giving up motherhood. Exhausted physically and emotionally, she reached the point where she no longer wanted to leave the house. “I didn’t want to see anyone, nor did I have the emotional conditions to undergo another fertilization.” No longer expecting to become a mother naturally, Maya signed up for the National Adoption Registry and, while fulfilling the required requirements, he ended up facing something he did not know and that made his dream come true – the Embryo adoption (embryoadoption)🇧🇷

When a couple undergoes assisted reproduction, in many cases more embryos are generated than will be used during treatment. The surplus, by law, must be kept frozen for at least three years and then discarded or provided for research. And it is precisely those embryos that are left over that can be adopted by those who cannot get pregnant.

The practice is still not widespread in Brazil. In one of the largest clinics in the country, for example, there were only 22 cases in 2017 (in the same period, Brazilian laboratories had 78,216 frozen embryos). Before adopting, the person opts for physical characteristics of the donor couple similar to their own (skin, eye and hair color, height, weight) so that the baby is born with similar traits, even without having their DNA. The donated embryos are transferred to the uterus of the woman who adopted them, and she is the one who will generate and give birth, like the biological mother.

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“I knew about the possibility of receiving donated eggs, but I didn’t know that I could adopt embryos. I spoke to my husband and he thought it was great, even though he knew they wouldn’t carry our genetic characteristics. We really wanted to be parents, and this was an alternative that we needed to try before resorting to standard adoption”, recalls Maya.

Two months after looking for the doctor to say that they were willing to undergo the procedure, they were informed that there were four embryos available with the profile they wanted. “It was one of the happiest days of my life. I prepared the endometrium and we transferred two of these embryos. I got pregnant with twins, and today I have two beautiful children”, says Maya, who is the mother of Ricardo* and Rafael*, who are 1 and a half years old.

WHO CAN ADOPT

THE adoption of an embryo it has been allowed in Brazil since the resolution of the Federal Council of Medicine (CFM) on the subject, in 1992. “But 15, 20 years ago there were no thawing techniques that guaranteed the survival of embryos with quality. Adopting them was therefore rare. This has changed a lot in the last ten years and has awakened the interest of couples who seek help in assisted reproduction and no longer have alternatives using their own genetic material”, explains Hitomi Nakagawa, president of the Technical Chamber of Assisted Reproduction at CFM.

Businesswoman Sarita*, 33 years old, faced three cycles of in vitro fertilization before choosing to adopt embryos. She and her husband decided together, certain that they no longer wanted the stress of trying to produce a baby with their genetic material. “I am a spiritist and I believe that these two embryos were already my daughters. I could have made 200 attempts with my DNA and I wouldn’t have been able to get pregnant”, says Sarita, mother of Bruna* and Bianca*, 9 months old.

Experts do not recommend that adopting embryos be the first option for those who have difficulty conceiving. Firstly, it is necessary to identify the cause of the couple’s infertility and go through the other existing alternatives: artificial insemination (in which the husband’s semen is injected into the woman’s uterus); in vitro fertilization (when the egg and sperm are fertilized in a laboratory); reception of eggs (with better quality, usually from younger women); or reception of semen, if the problem is the man’s.

THE embryo adoption it appears as hope to generate a child when both the man and the woman have fertility problems or never discover the reason for not getting pregnant naturally; when the woman is already in menopause or is older and wants to opt for an independent production.

It was like this with the journalist Carla*, 45 years old. She already has a biological daughter from her first marriage, but wanted to be the mother of another child via independent production. Separated and nearing menopause, she no longer produces quality eggs. After maturing the idea for two years, she decided to adopt an embryo. Today she is in the process of preparing her uterus to receive two embryos.

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The same happened with nurse Marília*, 39 years old, who adopted three embryos after discovering that she and her husband carried genetic defects in their DNA, capable of causing important changes in the baby’s development. “The tests showed that the chances of us getting pregnant naturally were rare. And rarer still would be to have a healthy baby.”

The couple began the process of trying to conceive using their own genetic material and selecting only healthy embryos. Failed. After doing a lot of research on the subject, he opted for embryonic adoption. They are now the parents of Gabriela* and Isabela*, twins aged 1 year and 3 months.

DECISION TO DONATE

Embryos are only put up for adoption with the consent of the biological parents. Administrator Flávia Monik de Souza Nicolau, 42 years old, donated her two surplus embryos. “In those embryos there was life, we didn’t want to throw it away. We donate with an open heart, with all the love”, says she, who underwent eight fertilizations until she managed to get pregnant with twins. “I said a prayer as we were signing the donation document asking them to make a happy family.”

Flávia reports not worrying about the possibility of having two biological children out there. She claims that if the kids ever wanted to meet her, she would welcome them. “And I would say to love the adoptive parents very much, who gave up their DNA in the name of love.” Lawyer Márcio Maia Palmar, 39, Flávia’s husband, says he doesn’t know how he would react if that happened.

Although there is no specific legislation on embryo adoption, donor confidentiality is guaranteed by CFM resolution. Donors and recipients must sign a consent form. Despite the document, the topic is controversial because article 48 of the Child and Adolescent Statute (ECA) states that “the adoptee has the right to know his biological origin, as well as to obtain unrestricted access to the process in which the measure was applied and incidents, after reaching the age of 18”.

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According to Silmara Chinellato, professor of civil law at the USP Faculty of Law, anonymity is illegal and goes against the right to know one’s origins and genetic identity. “It is a right guaranteed by the ECA, although the exercise of this right is not a basis for deconstituting paternity or maternity established in favor of who adopted the embryos. She explains that it is possible to legally request the recognition of biological paternity, if the adopted person wants to. The recent and controversial decision of the STF allows the name of all parents to appear in the birth registration.

In Silmara’s assessment, Brazil needs to have legislation on assisted reproduction to ensure greater legal certainty and less uncertainty for those involved. Recommends that the act of adopting embryos should be done by public deed.

As for the lawyer Thaís Ribacionka, master in bioethics, despite the ECA article, the maintenance of non-identification in adoption, both in the standard and in that of embryos, is consolidated in Justice. “The issue of anonymity is very strong and very well established in Brazil.”

TO COUNT OR NOT TO COUNT

Doctor Thaís Domingues, from the Huntington reproduction clinic, explains that every couple that is going to undergo some type of adoption (whether of an embryo or a child that has already been born) goes through an acceptance process. According to her, in the case of the embryo, it is the man who tends to be more resistant. “The woman, even not using her egg, will carry this embryo for nine months. Once she starts to feel it grow, move, she won’t even remember that she doesn’t have her genetic material. She will be the mother of this baby, no doubt, but the man may not feel like the father.”
Because of this type of problem, it is recommended that every adoptive couple undergo psychological counseling.

It was precisely the lack of this psychological support that, to this day, makes housewife Fabiane*, 41 years old, look at her son, Fernando*, 4 years old, and think that he doesn’t look like her or her husband. Fernando is the result of an embryo adoption made after Fabiane found out she had a chromosomal alteration. “The love I feel for him is incredible, he is my son, nothing changes. But I missed psychological preparation, I’m not going to lie. I still blame myself a lot for not carrying our DNA.”

Unlike what happens in adoption of a child, in the embryo there is a period of normal pregnancy. Therefore, another point that usually comes up is whether or not to tell the family and, in the future, the child about the procedure. Questions like “What if you want to meet the biological parents?” or “What if she has a hereditary disease and needs genetic material?” surround those who adopt.

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Most parents who adopt embryos choose not to tell even their family members about the adoption and decide to keep it a secret for the rest of their lives in order to protect their children from possible acts of prejudice.

“We didn’t tell anyone. We don’t think it’s fair that other people know my children’s story before they do,” says physiotherapist Maya. Sarita shares the same sentiment and emphasizes that it is not up to anyone – apart from her and her husband – to know such an important detail of their family’s life.

“It may seem like I’m keeping a secret, but I don’t see it that way. I’m just trying to avoid creating confusion in my daughters’ minds.” Carla and Marília state that they intend to tell their children the truth as soon as they are able to understand what happened and what the procedure they were part of is like. “A lie breeds another lie and I don’t want that for my son/daughter in the future. Hopefully in a while people will be a little more open-minded as this isn’t the end of the world. It is an adoption like any other”, says Carla.
Marília reports that she intends to reveal to her daughters about the adoption process because medicine has evolved a lot. “We froze the cord blood as a precaution to deal with potential health issues in the future.”

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For the doctor José Geraldo Alves Caldeira, from Clínica de…