In California, a Small Bundle of Medical History Arrives on Time: the First U.s. Frozen Embryo Baby
For Monique and Gary it is the birth of their first child, and the delivery by cesarean section is proceeding normally. "Okay," the doctor says, "here he comes, I've got his head." Monique strains to sit up to catch a glimpse of her son, weighing into the world at a robust 9 pounds, 10 ounces. "Oh God, Gary," she says softly to her husband, who is clutching her hand, "look at him, he's beautiful."
The happy event occurred at 12:54 p.m. on June 4 at a Los Angeles area hospital and appeared almost routine, but it most certainly was not. Monique, 136, and Gary, 47, himself a physician, are the first parents in the U.S. to have a baby by way of a frozen embryo.
Though a TV news crew witnessed the historic birth, the parents insisted on partial anonymity, allowing only their first names to be used and refusing to disclose the name of their newborn. "Our privacy is important," Monique insists. She and Gary agreed to limited press coverage, she explains, only to send a message of hope to an estimated 4½ million infertile couples in the U.S. who, like themselves, have endured years of disappointments. "I wanted to tell them to never stop believing, never to stop trying. It can be done; it is being done."
To date, more than two dozen babies have been born through the frozen embryo technique in Australia, Britain, Israel, the Netherlands and West Germany. In the U.S., 10 of the 136 medical groups with in vitro fertilization (IVF) programs are gearing up to use frozen embryos. There are now at least three other frozen embryo pregnancies in this country. One is under the care of Dr. Richard Marrs of Good Samaritan Hospital in Los Angeles (who was also Monique's physician), another is being supervised by Dr. Glenn Zorn of John Muir Hospital in Walnut Creek, Calif., and a third was confirmed last week by embryologist Mary Forster at Seattle's Swedish Hospital.
The freezing of embryos is an extension of the IVF technique that thrilled the world with the 1978 birth in Britain of Louise Brown—history's first "test tube baby." Under standard IVF procedures, fertility drugs are used to stimulate ovulation, producing as many as a dozen eggs. These are then surgically extracted, fertilized with the father's sperm in the laboratory and then allowed to develop for about 48 to 72 hours. Finally a number of fertilized eggs are implanted in the uterus in hopes that at least one will grow into a fetus. But while IVF can be used to bypass such infertility problems as blocked fallopian tubes and poor sperm function, the odds against initiating a lab-fertilized pregnancy are 5 to 1.
Even so, doctors ordinarily do not implant all the fertilized eggs so as to reduce the possibility of multiple births. Prior to the advent of embryo freezing, or cryopreservation, unused embryos were discarded. Monique, for example, underwent three IVF procedures unsuccessfully, starting over each time. On the first and third occasions, however, Dr. Marrs froze a total of four unused, fertilized eggs. "The purpose of cryopreservation" he explains, "is to make IVF more efficient. If the woman doesn't become pregnant, we simply thaw out the stored embryos and implant them in a quick, nonsurgical procedure that can be done in the office." Cost of this last procedure: about $500.
Embryo freezing is done in a computer-controlled device resembling a small fridge. Dr. Marrs carefully lowers the temperature at the rate of .3°C per minute until the fertilized eggs reach—76°C. They are then immersed in liquid nitrogen and stored at—196°C. Thawing is done by reversing the procedure until the embryos reach room temperature.
According to Dr. Kathryn Honea, medical director of IVF Australia, which offers programs in Port Chester, N.Y. and Birmingham, Ala., the miscarriage rate with frozen embryos (25 percent) is nearly identical to that of the standard IVF. "This suggests that the embryos are not damaged by freezing and thawing," she says. The cost of one-year's storage runs about $500.
Monique has known since she was 21 that she was infertile, a condition that Dr. Marrs believes was caused by damaged fallopian tubes. "I come from a family of seven children, and I couldn't live without a child in my life," she says. Her three vain IVF attempts had cost more than $12,000. The couple also tried to adopt, but were told that Gary was "too old." Skeptical about embryo freezing, they went along to humor the doctor. And, Monique adds, because "I didn't want to grow to be 80 years old and childless and think there was something I could have done and didn't do."
Only a week after her frozen-and-thawed embryos were implanted last fall, Monique was certain she was pregnant, despite her husband's assurances that "she couldn't possibly be so sure so soon." A blood test a week later proved Monique's hunch correct, and Dr. Marrs's prediction of "a healthy baby, normal in every way" has now been confirmed. "We waited 15 years for this," says Gary. Cuddling their son, Monique adds, "He's worth every single minute of it."
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