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Maybe you’ve decided that your family is complete or have opted to stop pursuing treatments. Perhaps you’ve chosen not to transfer certain embryos due to chromosomal abnormalities or can no longer afford the cost of embryo storage. No matter what your mindset is, deciding what to do with your remaining embryos after IVF can be a very personal–and difficult–choice.
As Embryologists, we are often so focused on making sure our patients get viable embryos that we fail to talk to them about the options available for the embryos they may not use. All IVF patients are required to sign embryo disposition forms at the start of each cycle, but do you actually know all of the options available to you when it comes to what to do with the embryos you don’t end up transferring? Well, I'm here to break it down for you.
The goal of embryo disposition is to decrease the number of embryos that are abandoned. That’s the reason for the consent forms, where you morbidly have to consider what to do with your embryo(s) if you (or your partner) were to die or split up. Most clinics have hundreds of embryos that are considered “abandoned” because the clinic is no longer able to get in contact with the patient, and they are no longer paying their storage fees. It's very difficult to decide what to do with these embryos because any decision the clinic makes requires the patient's consent. In these cases, the embryos end up sitting in storage for years.
What to Do With Unused Frozen Embryos
1. Continue storage
The most common option is to continue storage! Most clinics allow patients to keep their embryos on-site for as long as they’d like, as long as they are paying for cryopreservation. This might make your decision easy, if you are leaving the door open to the possibility of having another child, or if you are not yet ready to make a more definitive decision.
Some clinics, on the other hand, may only allow you to store your embryos onsite for a certain length of time or if you are actively in treatment. This is usually because they are running out of storage space in their tanks. If this is your situation, there are a few long-term storage facilities in the United States (Reprotech, Fairfax, etc.), where you can keep your embryos stored for up to 10 years at a time.
2. Discard unused embryos
In my experience as an Embryologist, choosing to discard embryos is the most common choice amongst patients who know that they no longer want to use them. Once we have received consent, we then discard the embryos into biohazard trash. This is a two-person process since all embryo labels and consents are verified by two people before discarding. This ensures that the correct consents have been signed and the correct embryos are discarded. It is standard to have the embryos discarded after 30 days from the signed consent. This leaves time in case the patient changes their mind.
3. Donate to science
Donating embryos to research or science is an option that I get asked about a lot since there seem to be a lot of misconceptions about what this means or how to do it. In short, it depends on the clinic. If the clinic is actively involved with a research project, they will give you information and consents to outline exactly what will happen to your embryos during the study. Ultimately, the embryos are discarded at the end of the study.
I should also note that there are a lot of laws and regulations that limit what can actually be done with embryos that are donated to science, so try not to worry! Most embryos that are donated to research are used to train new embryologists. We rely heavily on these embryos for our training; they are used to practice thaw, vit, biopsy, hatching, and more. These embryos can also be used to test new culture media and equipment and try out new techniques. Again, ultimately, the embryos are discarded at the end of training.
4. Donate to another family
The only option that can result in a potential pregnancy is donating your embryos to an agency or donor embryo program. This can be done anonymously, to someone you know, or through an agency that matches you with a family based on your parameters. Some clinics have in-house donor embryo programs, but these are often anonymous unless you have a specific couple in mind.
Embryo donation does require additional consent and sometimes even some FDA bloodwork. If you do decide to use an agency, keep in mind they may have more strict requirements for donating, and it could take a while to be matched.
5. Take your embryo home!
The last disposition I want to highlight is the option of taking your embryo home. I have seen a few patients do this over the years, and I always think it’s such a great idea. Technically, once we’ve taken the embryo out of its liquid nitrogen, the embryo will die very quickly, but it allows the patient to remember and honor the embryo in the way that they please. When patients have done this in the past, we have had them sign to discard the embryo(s) first. We have then verified all labels and consents before bringing them the straws for them to keep.
Deciding what to do with your remaining embryos when you’re done pursuing IVF can be a tough choice, but remember that your clinic needs your consent before doing anything to your embryo(s). Your clinic may not offer all of these options, but if there is one that you’re interested in pursuing, it never hurts to ask. Many clinics are willing and able to fulfill special requests from their patients. Until then, they’ll remain safe and sound in their tank, ready when you are.
Alease Daniel is an Embryologist and experienced IVF Laboratory Technician residing in Raleigh, North Carolina. In her free time, she enjoys baking and cooking with her husband and playing with her two pups! You can follow Alease on Instagram at @alease_the_embryologist or TikTok at @aleasetheembryologist.