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When the embryo in your womb isn't yours

This multicelled human embryo, a few days old, is from a British fertility lab. A mix-up in a Japanese lab led to what may  be the first wrong-embryo abortion.

Associated Press

This multicelled human embryo, a few days old, is from a British fertility lab. A mix-up in a Japanese lab led to what may be the first wrong-embryo abortion.

Would you abort a fetus just because it wasn't yours?

The question sounds crazy. How could it not be yours? If it's in your body, you must be the mom, right?

Wrong. Through in vitro fertilization, you can get pregnant with somebody else's fetus. Thousands of surrogates already have. You can also carry an unrelated child using donor eggs and sperm. But these are things you'd have to sign up for. The scary scenario is the one you never expect: going through IVF and discovering, weeks into your pregnancy, that your doctor put the wrong embryo in your womb.

If you think this can't happen, I have bad news: It just did. A public hospital did it to a woman in Japan. Now she's suing the local government for more than $200,000, claiming mental anguish.

How did it happen? Simple. The doctor got two dishes mixed up. Here's the time line, as far as we know: On Sept. 18, the doctor transferred two of the woman's embryos to her womb. On Sept. 20, he added a third embryo — the unrelated one. On Oct. 7, he told her she was pregnant. Around Oct. 16, he started to suspect the growing embryo wasn't hers. On Nov. 7, he explained what had happened and told her she was probably carrying another woman's child. On Nov. 11, with the couple's consent, the pregnancy was aborted.

If this time line holds up, the embryo grew for 54 days in vivo. Add a few days of cultivation in the dish, and you're looking at 8 weeks of development — technically, a fetus. The couple has filed suit, and the hospital has held several news conferences, with each party divulging details. Yet nowhere in the press accounts is there any suggestion, much less evidence, of a fetal or maternal health problem. If either party could invoke such grounds for the abortion, you'd think they would have. But they haven't. It seems to be a straightforward case of aborting a fetus because it came from the wrong family.

Or, rather, because it may have come from the wrong family. Remember, the first two embryos that went into the woman were hers. For complex reasons, the doctor inferred that the one that had grown was the third one. According to the Yomiuri Shimbun, doctors told the woman on Nov. 8 that "it was not possible to confirm the source of the fertilized egg at that time, but they could analyze the mother's amniotic fluid in six weeks. However, if she waited that long, it would be too late to terminate the pregnancy." Apparently, the fetus was subsequently discarded, leaving no way to settle the question.

Now the parties are disputing which of them pushed for the abortion. The couple's suit, as described in a wire report, alleges that "they reluctantly terminated the pregnancy under hospital guidance" after doctors "recommended an early termination … telling (the woman) not to wait until amniotic fluid analysis could be conducted for confirmation of the fetus' identity due to risks to the mother." A hospital official describes the exchange differently: "We just explained to her about the risks of abortion in the period after an amniotic fluid scan but did not recommend abortion."

Where do I start with this twisted story? In the Japanese press, there's a suggestion of scandal because, absent definitive tests, the fetus might actually have been the couple's own flesh and blood. If it was, the story goes, then the hospital must be called to account for persuading them to abort their own child, when they innocently thought they were aborting somebody else's.

That somebody else, a fellow IVF patient, was in the same hospital all along. Nobody consulted her about the abortion or even told her about the pregnancy. Not until Jan. 25, a full 21/2 months afterward, did doctors tell her and her husband what had happened. The doctors claim she was too weak to be burdened with the bad news.

From a prolife standpoint, the whole thing is grotesque. But from a prochoice standpoint, it's agonizing. One woman who wanted a child aborted carried in her own body another woman's healthy, wanted child. It's generally understood that if you hire a surrogate to carry your embryo, she, not you, gets to decide whether to abort it. It may be your baby, but it's her body, and that's the legal trump card. A woman who's carrying your child against her will, as in the Japanese case, presumably has an even greater right to end the pregnancy.

But what about you? You didn't sign a surrogacy contract. You made that embryo so you could give it life yourself. The doctor picked it because it looked like a good candidate to become a child, and the subsequent pregnancy proved him right. A healthy child, your child, was terminated without your consent, consultation or knowledge. Is that right?

If you think this is an easy call, hang on: It gets worse. The woman who aborted the fetus was in her 20s. The woman who lost it was in her 40s. If the elder woman has since become pregnant, I can't find any record of it. Can you imagine losing your last chance at motherhood this way? What would you have said to the woman carrying your child, if you'd had a chance to speak to her in time?

The Japanese fertility establishment swears a mix-up like this has never happened before and won't happen again. Really? There are at least five other known cases from England and the United States. All of these mix-ups led to births except one: a 2002 incident in which, according to the London Evening Standard, two women who got the wrong embryos were informed of the mistake "within hours," and "an emergency technique was carried out to flush the embryos from their wombs and they were given drugs to ensure there was no risk of pregnancy."

The number of babies born worldwide from IVF and other assisted reproductive technologies is fast approaching 4 million. In Japan, one of every 60 kids is an IVF product. A year ago, according to the Yomiuri Shimbun, half the Japanese fertility centers participating in a survey "said they understood how medical accidents could occur" at their facilities. Thirteen admitted to medication errors, and two "said they had mixed up their patients." If that's how many clinics acknowledge such errors, imagine how many have actually committed them.

Maybe this was the world's first wrong-embryo abortion. But with more than 1 million IVF cycles being processed around the world each year, my bet is that it has happened before and will happen again. Next time, I hope, the woman who conceived the embryo will get a chance to talk to the woman who decides its fate.

William Saletan is Slate's national correspondent and author of Bearing Right: How Conservatives Won the Abortion War.

When the embryo in your womb isn't yours 03/21/09 [Last modified: Saturday, March 21, 2009 4:31am]
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