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Embryo Disposition Decisions

Lesson 2 of 4

Options Available

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Overview

The choices you have available regarding your frozen embryos will vary greatly depending on the laws and regulations in your region. Options vary from country to country, and even state to state. Your own clinic’s policies will also impact the available options. Having a conversation with your clinic or doctor is essential in ascertaining which options are an option for you.

To overly simplify, we tend to think of your options falling into one of the following categories: keep embryos frozen, donate to another patient for reproductive purposes, donate to science, thaw for personal ceremony, or thaw and discard.

Keep in Storage

In this option, your frozen embryos will continue to be kept in storage, and you’ll continue to owe storage fees. Your embryos will be available to you should you decide to take advantage of another option at a future time.

If you are considering or are open to the idea of a future attempt at pregnancy, keeping your embryos in storage is a pretty clear solution.

But even people who are not entertaining the idea of future pregnancy may opt to keep their embryos in storage. For some people having embryos in storage feels a bit like an “insurance policy” and allows them to keep their options open.

Most data to date has been reassuring that embryos stored over a longer period record no lower odds of implantation. Below you can see data from one well-regarded study out of China appearing in the Journal of Assisted Reproduction and Genetics in 2014.

A downside of this option is cost. At least within the United States and countries like Australia, the average embryo storage cost is often $500 or more. And this can really add up over time.

If you’re considering keeping your embryos frozen for an indefinite period of time, you may consider moving them into an established long-term storage facility, where the annual cost is lower. While shipping embryos between facilities is common in some regions, it’s not without theoretical risk, and before considering such an option, you'll want to discuss a few factors with your doctor and all parties involved, namely:

  • Who will be responsible for ensuring the embryos are safely moved between locations
  • What certifications and standards of accreditation are customary for the local fertility clinics and the outside storage facility?
  • Does the storage facility track how often embryos stored in their facility are able to be thawed and used in an embryo transfer. For context, most fertility clinics are able to successfully warm and use 95%–99% of the embryos they freeze.
  • Should you want to use embryos stored in a long-term facility, will your clinic accept them back to transfer

If this is an option you’re considering, we suggest you consult our laboratory course here, where we cover best practices and risk mitigants in the laboratory setting.

Storing embryos indefinitely is not an option in every country. The U.K. and New Zealand, for example, have time limitations on embryo storage. Some clinics also have limits on how long they are willing to store embryos. Be sure to check with your own clinic about any storage limitations.

Donation to Scientific Research

Another option is to donate embryos for use in scientific research. In this option, you no longer pay storage fees and your embryos would be utilized for research in the lab. Research may include studies on embryological development or human stem cell research.

In many cases, donated embryos are discarded according to laboratory policies after use; however, it is important to note that some studies you have the option to donate to may create permanent cell lines that may continue to propagate indefinitely. Regardless, the embryos donated to science will never be used for human reproduction.

The option of donating embryos to science is one that tends to be appealing to patients. As one example, in countries like Belgium where the option is readily available, studies show it’s by far the most popular decision.

However, in many countries (e.g. the United States, Germany) this option is far less available. Historically, few research centers in the United States accept human embryos for research, and the few that do tend to only accept embryos created in their own center.

At this time, we are aware of only one research facility currently accepting outside embryos. In January 2021, the Renew Biobank at Stanford University in California oppened their program to recieve embryos, oocytes, sperm, and other reprodutive tissue. The availability of this option may vary by the state in which you live or your embryos are stored, and we recommend contacting the program directly to learn more.

Donation for Internal Training

As an alternative to donating for scientific research, some clinics will allow you to donate your embryos to the lab for quality assurance work and training of laboratory personnel. The end result is that the embryos are thawed & ultimately disposed of, but in the process, embryologists are given the opportunity to practice essential skills such as biopsying an embryo for PGT-A testing. These embryos are never used for reproductive purposes.

Donation to Others

Some people donate remaining embryos to an individual or couple who will then transfer the embryo in hopes to achieve a pregnancy of their own. This is called embryo donation. In this case, the recipient of the donated embryos raises any resulting children as their own—similar to pregnancies achieved through egg or sperm donation. However, unlike pregnancies achieved through egg or sperm donation, the resulting children are often full genetic siblings of the donor’s children and have no genetic link to the parents who are raising them.

People who choose this option are often motivated by a sense of altruism and a desire to help other hopeful parents build their family. However, the long-term implications of having your genetic children raised by another parent often present a point of concern and complicates the decision.

You may have heard the term “embryo adoption” used to describe this scenario. We think it’s important to point out that though the word “adoption” is used colloquially, an embryo donation is not an adoption. At least under United States law, embryos are considered property, and property cannot be adopted, it can only have ownership transferred.

Donation of embryos for reproductive purposes involves a fair amount of logistical work and can be complicated. Due to its complex nature, we’ve dedicated more time to the topic in the next lesson.

Thaw for Personal Disposition

Some patients wish to no longer store their embryos but want an opportunity to acknowledge the importance of the embryos in their lives. This disposition option may be considered for personal or religious reasons. It’s important to note that this option may not be available at every IVF center.

In some cases, patients may ask for their embryos to be released to them for a private burial or ceremony.

Others may request to undergo a “compassionate transfer” in which case the embryos are thawed and transferred into the vagina or uterus at a time in the menstrual cycle that is incredibly unlikely to result in a pregnancy.

Not all clinics will agree to facilitate a compassionate transfer, and there are still risks involved. Though unlikely, some clinicians have voiced concern about the risk of an ectopic pregnancy. This option may also drive additional expense to pay for the cost of the transfer, which averages around $3,000 in the U.S.

Thaw & “Discard”

The thaw & “discard” option is essentially what it sounds like. Embryos are thawed in the lab and then disposed of according to lab policies. Not all IVF programs allow for the discarding of embryos.