Embryo Project Encyclopedia Articles

In 2001, the Supreme Court of New Jersey decided a dispute between a divorced couple over cryopreserved preembryos created through in vitro fertilization (IVF) during the coupleÕs marriage. The former wife (J.B.) wanted the preembryos destroyed, while her former husband (M.B.) wanted them to be used for future implantation attempts, such as by an infertile couple. In J.B. v. M.B. (2001), the court declined to force J.B. to become a parent against her will, concluding that doing so would violate state public policy. Instead, the Supreme Court of New Jersey decided that agreements directing the allocation of cryopreserved preembryos will be enforced, unless one party changes his or her mind prior to the preembryosÕ use or destruction. Should a party revoke an earlier decision about the preembryos, New Jersey courts should weigh the partiesÕ interests with special weight given to an individualÕs right to not procreate.

William Thornton Mustard was a surgeon in Canada during the twentieth century who developed surgical techniques to treat children who had congenital heart defects. Mustard has two surgeries named after him, both of which he helped to develop. The first of these surgeries replaces damaged or paralyzed muscles in individuals who have polio, a virus that can cause paralysis. The other technique corrects a condition called the transposition of the great arteries (TGA) that is noticed at birth. Surgeons worldwide adopted that technique, leading to increased survival rates in infants afflicted with the condition. Mustard also published over 100 articles on congenital heart defects, surgical techniques, and the preparation of an artificial heart lung machine. Mustard helped perform the first blood transfusion of a newborn whose red blood cells (RBCs) had degraded, a condition called hemolytic anemia. Throughout his career, Mustard developed surgical techniques that increased the survival rates of infants and children with congenital and developmental disorders.

Ignaz Philipp Semmelweis demonstrated that the use of disinfectants could reduce the occurrence of puerperal fever in patients in nineteenth century Austria. Puerperal fever is a bacterial infection that can occur in the uterine tract of women after giving birth or undergoing an abortion. Semmelweis determined that puerperal fever is contagious and argued that the unhygienic practices of physicians, like examining patients after performing autopsies, caused the spread of puerperal fever. He showed that if physicians washed their hands with a chloride solution before they attended patients, then they prevented those patients from developing puerperal fever. Despite being widely criticized during his lifetime, Semmelweis's research on the contagiousness of puerperal fever set a precedent for many scientists, and contributed to preventing the spread of puerperal fever.

Transposition of the great arteries or TGA is a potentially fatal congenital heart malformation where the pulmonary artery and the aorta are switched. The switch means that the aorta, which normally carries oxygenated blood, carries deoxygenated blood. There are two types of the malformation, d-TGA where no oxygen reaches the body and l-TGA where some oxygenated blood circulates. In the US, the Centers for Disease Control estimate that about 1,901 infants are born each year with TGA, or about one for every 2,000 births. Throughout history, physicians classified TGA as a condition that causes blue babies and hypothesized it was a fatal condition. With the development of corrective surgeries, studies on the causes of TGA, and improved prenatal diagnosis have allowed for the survival rate for those with TGA to approach almost one hundred percent.

Adib Jatene in Brazil was the first surgeon to successfully perform the arterial switch operation in 1975. The operation corrected a heart condition in infants called transposition of the great arteries (TGA). Left untreated, infants with TGA die, as their blood cannot supply oxygen to their bodies. Jatene’s operation became widely used to correct the condition. Aside from medical research, Jatene worked for years in politics and education, serving as Brazil’s minister of health and teaching thoracic surgery at the University of São Paulo.

The arterial switch operation, also called the Jatene procedure, is an operation in which surgeons redirect the flow of blood through abnormal hearts. In 1975, Adib Jatene conducted the first successful arterial switch operation on a human infant. The arterial switch operation corrects a condition called transposition of the great arteries, abbreviated TGA, also called transposition of the great vessels, abbreviated TGV. TGA occurs when the pulmonary artery, which supplies deoxygenated blood to the lungs, and the aorta, which takes oxygenated blood to the body, are switched, or transposed. The switch between the aorta and pulmonary artery results in dangerously low levels of oxygen, a condition called cyanosis, in newborn infants, which causes them to die if a surgeon does not correct it.

In the case Randy M. Roman v. Augusta N. Roman (2006), the Court of Appeals of Texas followed courts in other states and upheld the validity and enforceability of in vitro fertilization (IVF) consent agreements. The Romans, a divorced couple, each sought different outcomes for their cryopreserved preembryos created during their marriage. Randy Roman sought to have them destroyed, and Augusta Roman sought to implant them in an attempt to have biological children. The Texas court, citing several related cases, declared that the written IVF consent form the Romans had signed would govern the outcome of the cryopreserved preembryos.

In the 2008 court case In the Matter of the Marriage of Dahl and Angle, the Court of Appeals of Oregon upheld a written in vitro fertilization (IVF) consent form signed by Laura and Darrell Angle, who had each contributed their genetic material to the creation of several preembryos during their marriage. Its decision followed the general framework for resolving such disputes provided by the Supreme Court of Tennessee in Davis v. Davis in 1992, which was subsequently followed by many courts across the US. The decision by the Court of Appeals of Oregon reinforced the idea that agreements that reflect the couple's intent at the time of undertaking IVF should be upheld, regardless of a later change of heart.

In re Marriage of Witten, decided by the Iowa Supreme Court in 2003, held that neither Tamera nor Arthur (Trip) Witten could use or destroy several cryopreserved preembryos created during their marriage using in vitro fertilization (IVF), unless the former couple could reach a mutual agreement. Tamera and Trip Witten, unable to conceive conventionally during their marriage, had attempted to start a family together using IVF at the University of Nebraska Medical Center (UNMC) in Omaha, Nebraska. When Trip sought to dissolve the marriage in April 2002, following several unsuccessful IVF attempts, seventeen of their preembryos were in storage at UNMC. The former couple disagreed about what should happen to the preembryos and asked the court for a resolution as part of the marital dissolution action. The high court of Iowa’s decision to restrict both individuals from using the cryopreserved preembryos without the other person’s consent reflected a belief that Tamera and Trip shared equal decision-making authority over the preembryos.

In the case York v. Jones (1989), the United States District Court for the Eastern District of Virginia was one of the first US courts to address a dispute over a cryopreserved preembryo. Steven York and Risa Adler-York (the Yorks), a married couple, provided their gametes to doctors who created the preembryo, which the court referred to as a pre-zygote, as part of an in vitro fertilization (IVF) program at the Howard and Georgeanna Jones Institute for Reproductive Medicine (Jones Institute) in Norfolk, Virginia. The couple sued when the doctors at the Jones Institute refused to release the preembryo to the Yorks for use at a different IVF clinic. The Virginia district court denied the Jones Institute's attempt to have the York v. Jones case dismissed, and instead upheld the Yorks' right to move forward with their lawsuit. The York v. Jones decision had important implications for future disputes over cryopreserved preembryos because it treated the Yorks' cryopreserved preembryo as legal property over which the Yorks retained decision-making authority.