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Embryo Disposition Decisions

Lesson 3 of 4

Understanding Embryo Donation

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Written Lesson

What Is Embryo Donation?

Embryo donation is a complex subject, and we think it warrants a deeper dive.

Embryo donation involves a transfer of ownership from the patient(s) who created the embryos, the donor, to another individual or couple wishing to build their family, the recipient.

The embryo is then transferred into the recipient's uterus, or that of a gestational carrier, and, if implantation occurs, is then carried, birthed, and raised by the recipient of the donated embryo.

Many patients view embryo donation as a way to “give back” to fertility patients and express a desire to help people who are struggling with infertility, a struggle they are well-acquainted. However, it’s not unusual for patients who initially indicate they’d be open to donating their embryos to ultimately decide against it.

Simply put, most prospective donors will need time and thoughtful consideration to determine if embryo donation is the best option for them. The realization that any resulting children are full genetic siblings of their own kids or that someone else will raise their genetic children is a mental hurdle that many patients find challenging to overcome.

For some patients, having a say in who the embryo recipient is helps overcome that emotional barrier and provide a sense of control.

Other patients feel genuine excitement at the idea of “paying it forward” to other hopeful parents. They remember their own struggle with infertility and see this as a way to help another fertility patient build their family.

The Process of Donating Embryos

For those who do move forward with cryopreserved embryo donation, there are often several steps in the process. For example, some embryo donation programs may require counseling, a psychological evaluation, and screening for the carrying of genetic diseases (for example, cystic fibrosis).

If you are interested in donating your embryos, you’ll need to make a decision about how you’d like to go about being connected with a recipient—often either through a private arrangement or a third party. The availability of either option may depend upon your location as laws vary by country.

Private Arrangement

Private arrangement embryo donations involve self-screening potential recipients often after being connected through a friend, social media, or an online group. While some patients feel comfortable with this kind of introduction, experts are wary of the risk of fraud and warn against making agreements or exchanging money without first seeking qualified legal and medical advice.

Having an experienced attorney is crucial in this regard, as they can help you avoid major pitfalls with long-term consequences.

Third-Party Arrangement

A second option is for a donor to be connected to a recipient through an agency. An agency, in this case, is only responsible for making the match and does not provide the services of a clinic to facilitate a frozen embryo transfer. The agency may charge matching fees, which are generally paid for by the embryo recipient, and can add thousands of dollars to the overall cost. A qualified IVF clinic will still be needed to facilitate the embryo transfer.

We should also highlight that many third parties will have their own areas of focus and priority and may only be prepared to work with donors and recipients in a specific region, or of a specific race, heritage, or religion.

IVF Clinic Donation Program

Finally, you have the option to donate through a clinic-run embryo donation program. In this case, the clinic is able to facilitate the arrangement, perform the embryo transfer, and provide general medical care to the embryo recipient.

Many IVF clinics have minimal experience with embryo donation and may also have a smaller pool of embryos to match to hopeful parents. Local patients sometimes voice concerns about donating embryos to their IVF center. Knowing the recipient may also live nearby, there is a risk of running into the genetic offspring in daily life.

So, while many clinics may have the ability to facilitate embryo donation, few do. In countries like the United States, the majority of embryo donation cycles are performed by a handful of full-service clinics.

Selecting a Form of Donation & Recipient

If a prospective donor works through a third party, often there’s varying degrees of identifying details they can request and information they can expect to receive. Terms may vary, but the below rubric summarizes the levels of information that may be available depending on your clinic or geographic location.

Even with an anonymous donation, you may have the ability to make requests about specific characteristics that are important to you when it comes to selecting a recipient for your embryos. For example, some people express concern about running into their genetic children at the grocery store or park. In this case, you may want to request a recipient who lives in a different geographical area.

It’s also important to note here that with the rise of home genetic testing, anonymity can no longer be guaranteed. If remaining anonymous is high on your priority list, this is something to consider.

Selecting a recipient is a highly personal choice and one that prospective donors tend to take seriously. In New Zealand, where all donors and recipients are required to meet in person, researchers found three primary themes that donors tend to evaluate potential recipients on. First, donors were looking for people who reminded them of themselves and who they felt they could build a good relationship with. Second, they looked for certain characteristics that they personally felt would ensure a “good” upbringing for the child. And finally,they sought out a commitment to disclosure about the donation and for the recipient to be open to information exchange (Goedeke, 2018). This stands in contrast to other countries, like India, where known-donation is either difficult or entirely not allowed.

Level of Self-Disclosure

Another factor in making a match is if, or when, the child will be made aware of their biological origins. While the recipient will determine what is shared about the child’s birth story with both the child and friends & family, the donor may have an opportunity to opt-in or opt-out of sharing identifying information about themselves.

With some third parties, donors have the option to share varying levels of information at different age intervals as the donor desires. For example, the donor may elect to have their contact information released to the recipient when the child reaches a specific age.

Embryo donation has seen a steady rise in popularity in recent years, with the number of transfer cycles just about doubling between 2014–2018.

We’ve also seen live birth rates generally improve during that time.