While you're trying to grow your family through IVF, you will have to make a temporary decision about what to do with future excess embryos. When you're still riding the emotional roller coaster of infertility, this may feel ridiculous. It’s almost inconceivable (pardon the pun) to think you will ever finish building your family and end up with more embryos than you need.
In this article:
- Exploring Embryo Donation
- Two Different Perspectives, One Common Thread
- Embryo Cryopreservation Facts
- What is embryo disposition?
- Your Embryo Disposition Options
- An Embryo Donor Shares How She Made Her Decision
- A Donor Embryo Recipient Shares Her Joy
- Consider Your Options Thoughtfully
- Should you explore embryo donation?
One big thing that isn't discussed enough in the fertility community is what your options are when it comes to deciding what to do with your "excess" embryos.
In addition to making an initial decision about the future of your embryos during in vitro fertilization (IVF) treatment, you will need to revisit this (sometimes difficult) topic when you are done having children and finally have the family you dreamt of for so long. Regardless of what your initial choice may have been, you eventually need to carefully consider your options and make a final decision.
In the process of building a family through IVF, embryos are created - but not all of them are always needed. For individuals or couples who have "extra" embryos they need to decide the fate of, what options do they have? How do they make a decision that feels right for them? And what should they consider as they make that choice?
The following article explores the facts (including what choices are available) as well as sharing the personal stories of two families - one couple who had to decide what to do with their unused embryos and one individual who created a family with donated embryos.
We will discuss some embryo cryopreservation facts and the basics of assisted reproductive technology (ART) sciences. We will then offer a very clear explanation of the choices available to you if you are faced with a surplus of embryos after completing your own family.
You will hear the beautiful story of one couple who completed their family-building journey and decided to donate their extra embryos - in the hopes of helping to make another family's dream of pregnancy and parenthood a reality.
Finally, a mother made possible by donated embryos shares the experience of receiving the gift of motherhood, given generously by someone else.
Want to read more stories? Meet one former patient who shares her journey to using donor eggs to build her family after struggling to conceive for over two years.
Embryo disposition is the technical term used to refer to the choices made around excess cryopreserved (frozen) embryos once an individual or couple has completed their family and decided not to have any more children via assisted reproductive technology.
Using a vastly simplified explanation, in vitro fertilization (IVF) is a process that involves retrieving eggs, adding sperm to egg, and monitoring any subsequent embryo development in the lab of a fertility clinic.
Note: Unused, excess, spare or leftover are other terms sometimes used to refer to embryos that remain cryopreserved (frozen) in storage after a family is completed.
There are a few possibilities to consider when choosing what to do with excess embryos. This is a deeply personal decision, and can be influenced by many factors, including religious beliefs. No matter what you choose, the most important thing is that you end up at peace with your decision.
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As one woman’s fertility journey ends, another woman's journey begins.
A former Illume Fertility patient who completed building her family walks us through the process, step by step, answering even the most challenging questions, including "Do you consider the embryos to be your children?"
She has participated in our Ladies' Night In and Pregnancy After Infertility support groups, as well as our Fertile Yoga classes. (Support groups can be a great place to process your emotions around these big decisions!)
She graciously consented to answer the questions below.
Q: Were you surprised to find that there was a consent to sign before you started IVF, in regard to disposition for excess embryos?
A: No, I wasn't surprised to find out there was a consent regarding disposition. Still, the paperwork and choices caught me off guard because you don't expect to have to make these sorts of decisions, even though it makes sense there is a consent.
Editor’s Note: These initial consents for embryo disposition are not binding. You will have the opportunity to revisit your decisions and alter them when you are finished with your own family building journey.
Q: Do you remember what your initial emotional/intellectual response was to the request for a decision about disposition?
A: It was such a whirlwind during those first visits - signing papers and meeting doctors. It's a lot of information at once, especially on your first visit to a fertility specialist! I remember looking at my husband and asking what he thought.
There was a patient navigator, or maybe it was a nurse, in the room with us, and there really wasn't an opportunity to talk about this particular topic privately. It's a big deal, and we were asked about this decision among so many other questions for intake. I just remember it being so overwhelming.
In the moment, we chose to donate to science or to another individual or couple. The idea of donating to other people was definitely in my mind, and I also remember feeling like that was a heavy choice. Afterwards, the request stimulated conversation between my husband and I about our own morals and values.
Q: How did you decide what to do with the excess embryos? What factors did you take into account?
A: We thought a lot about what we went through [on our fertility journey]. We knew right off the bat that we were not going to destroy them. There are people suffering from infertility, and we have an opportunity to give someone a chance. Could we live with the idea of destroying those chances? Could we live with the idea that children of our biological makeup are out there?
The choice to donate embryos to science was an easier decision because there wasn't any real emotional tie to it. I have a close friend who was going through fertility treatment due to a lack of eggs, and her chances were quite slim to be able to have a family. We realized we could make a direct impact by donating to someone, rather than an indirect impact by machine calibration.
Q: Did you have a change of mind or heart after making your initial decision?
A: Our only change of mind or heart was that we decided to help a couple/individual rather than donate our embryos to science. We saw more positive potential there.
Q: Were you aware or concerned with the screening process for your donated embryos?
A: I was not aware of the process, and I'm also not surprised there is a screening process. It has been a long process for me because I'm being so thoughtful during every step, sometimes taking weeks to complete each part. I want it to be right.
I got particularly hung up on an optional piece that asked if I wanted to share a letter to the potential recipient(s). That was hard for me. I didn't want to add too much or too little. How personal should it be - or not at all? Does someone want to know why we chose this? Do they even want to hear from me? It was very difficult to put down my thoughts.
Q: Did completing your family cause a shift in your feelings about remaining embryos?
A: After completing my family, I knew I wanted to give someone else the opportunity to create their own family. I don't feel an attachment to the embryos. It's wild to think that they are from the same batch as my daughter, but they aren't mine in any emotional sense.
Q: What are you planning on telling your children about the donated embryos?
A: We plan on telling our children the truth about our fertility process and that we donated the remaining embryos. It's so important in this day and age to be transparent about things like that, especially when there are DNA databases like 23andMe.
I couldn't imagine my daughter finding out she has a sibling through something like that and feeling like we kept a huge secret. We also thought about the medical benefits to those children and our own.
Q: Do you want to know if the donated embryos result in children?
A: It would be interesting to know if the donated embryos result in children. Just like for any of my fellow fertility warriors, I would be heartbroken if things don't work out. Not because of the embryos themselves, but because this is a huge decision for someone else to choose to use donated embryos. You go through so much to get to this point.
It would be devastating if she/they got this far and were still unable to complete their family.
Q: Are you open to having any children that result in the donated embryos contact you?
A: It would be incredible, in every sense of the word. Obviously, we understand privacy, and I would really have to think about the long-term impacts it could have on my own children. Both my child from the same batch, as well as my other child who does not have that same connection. First and foremost, I want to protect my kids.
Q: Do you see your embryos as your children? If not, how do you see the embryos, which consist of both your DNA and your husband's DNA?
A: No, not at all. We have always only thought of them as potential and possibility. I don't know if that is because through the struggles of infertility, you never fully get your hopes up. You're always waiting for the "bad news," so I was never attached to them as my own children. They are chances, possibilities.
I know that the emotional disconnect is the reason this decision has been easy. If there were any emotional attachment, I might be in a different situation. I can understand why someone would feel they wouldn't be able to donate.
Q: What would you like to say to the recipient of the embryos?
A: They are yours. They are not our children. We have our children and our family. I'm excited for you - hold on to hope!
Q: What would you say to any children resulting in your donated embryos?
A: Your parents are doing the best they can. And if you're ever having a hard time, just take a deep breath - you can overcome anything with a long deep breath and a clear head.
Q: How do you think you will feel if your children want contact with any children resulting from the donated embryos?
A: We've always given our kids free will and let them make their own choices (obviously within reason), so we would support any decision they made.
I would want to make sure they understood the magnitude of opening that door, and be sure that the other children wanted contact. How might it impact the parents? If everyone is open to it, there can't be enough love and support in the world.
Q: What would you like to tell others about the choice you made to encourage them to donate embryos?
A: We went through the emotional, psychological, financial, physical demands of infertility just for the CHANCE to have a child. There are no guarantees. We went through several rounds of IVF, and thankfully were able to conceive.
For those who haven't been so fortunate, we are giving them another opportunity. We have something of great value that we don't need and won't use - something others are longing for. We didn't go through all this to have embryos sitting there that someone could use.
Why wouldn't we donate?
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*Content Warning: Suicide*
Now that we've heard from an embryo donor, let's hear the story of a donor embryo recipient. This former Illume Fertility patient shares the story about how she expanded her family thanks to another family’s generosity.
As you'll read, coming to the decision to accept a donated embryo may have been complicated, but accepting and loving the child that resulted from that embryo was simple.
Q: How did you start off trying to build a family?
A: So, this all starts off when I had a husband. We tried unsuccessfully to have a baby for several months. I was convinced it was just bad luck, but I walked into Illume Fertility (then RMA of Connecticut) for testing to just "get a handle" on my ovulation. As it turns out, I am very normal in that I am aging, meaning my ability to conceive is greatly reduced. Yay, me!
It was recommended that we go straight to IVF (which my insurance covered 100% - and I know I'm incredibly lucky to say that). I was a "non-responder" the first round. In my second round of IVF, five eggs were retrieved, three fertilized, but none made it past day three. It was at the start of my third attempt where we had to cancel the round.
Tragically, my husband had a mental breakdown, later dying by suicide. Now I was left without a partner but still wanted - more than anything - to be a mother. Several months later, I walked back in to Illume Fertility and had a very straightforward conversation with my doctor.
Q: When did you first learn about the possibility of embryo donation?
A: I found out about embryo donation for the first time when Lisa Rosenthal mentioned it during a Ladies' Night In peer support group.
Q: What did you think about it when you first heard?
A: So, here's the deal...nobody wakes up and says, "I want a donated embryo and to have a baby that way." Nobody says "I want to wait until I am almost out of eggs and then try and try, hoping for the magic positive pregnancy test that has around a 12% chance of happening each month, even for a younger woman."
For that matter, nobody wants to become so well-versed in infertility that they know all the statistics. Personally, I would rather be keeping track of the Yankees stats than when I am ovulating, what my blood levels are, and how much more time I have before I am out of time.
As time went on, and things weren't going the way they needed to go, I thought about donor embryos more and more as a viable possibility.
Q: What did you consider when making the decision to use a donated embryo? What feelings did you have to overcome?
A: The only thing I really considered was that it was my best option to become a mother while being able to carry the baby. I had already come to the conclusion that without a lot of luck, I was probably going to have to consider using an egg donor. I had become comfortable with the notion that the child I carried might not have my DNA.
So embryo donation was a no brainer for me. If it worked (nothing is 100% right?) then I would be able to carry and give birth. I was going to be a mom. Let me tell you...every shot...every pinch...every ultrasound...all of it became so worth it when I heard that little heartbeat for the first time.
Q: What did your list of pros and cons look like when you realized you might be a candidate for embryo donation?
A: The pros? Have a baby, a chance to carry that baby, have the opportunity to give birth, with no man needed. Cons? I didn't have any!
Basically, all my lists said this: I WANT TO BE A MOM. I screamed it out loud (and in my head and heart) so many times. Hearing I had a 2% chance (at best) of ever having my own child was like a punch to the gut. But I wanted to be a mom. I wanted to carry a baby and give birth. I was not giving up on this. One way or another...I was going to become a mom.
Q: Did you feel differently than you thought once you became pregnant?
A: I was so excited when I found out I was pregnant. Elated! Terrified! That was the one feeling I wasn't expecting. I was so afraid I was going to lose the pregnancy once I had it. It seemed like such a dream come true. I was terrified to have it taken away.
Being pregnant was incredible. I was determined not to complain at all. I was so grateful! I found myself forgetting...saying things like, "I hope he has my...." and then laughing. He is mine! There is no doubt. He grew in my belly and knew me when he came out.
To this day, when I walk in the room, he has a special smile just for me. He is so excited to see me. I find myself wondering just how much genetic crossover happens in the womb. This child of mine has my father's eyes and my grandfather's ears. And he has my hair! Go figure. I joke that I couldn't have done better if I'd ordered him from a catalog.
Q: Who did you share your choice with? Were they supportive of your decision?
A: My family and close friends were aware of my decision, as well as the Ladies' Night In group. Everyone was very supportive.
Q: How did you feel right after your child was born?
A: Who can remember? Ha! I was in labor for over 24 hours and finally went in for an unplanned C-section. I was exhausted and got sick on the table. And then when they held up this little face over the sheet, all covered in white goo...I just wanted to hold him!
Q: What would you want to say to the people who donated the embryo?
A: You are my heroes, and thank you.
The woman who gave her embryos for someone like me is legitimately my hero. Without her, I wouldn't be a mom. I do not know what I would say to her because there just aren't words. She has gifted me my heart and soul embodied on this earth - my son.
Q: What will you tell your child?
A: I will tell him the truth. I will also make sure he knows how wanted and loved he was and is.
Our social worker told me to always be honest with him. I know one day he will probably want to find his sister (he has a sister who is a few years older). Databases like ancestry.com almost guarantee he will find his genetic relatives one day - if he wants to.
I would love to say I know I will be okay with that...but I can't. I don't know how I will feel about it. I pray he will always love me. I am his mom. I will raise him to know what a miracle he is and how much he is loved and was always wanted.
Q: When you look at your child, do you have any doubts that you made the right family-building decision for you?
A: Not even one. Never.
Making the important and permanent decision about what to do with excess embryos will be yours to make when your own family-building journey is complete. Yes, you will sign consents at the start of your IVF cycle, but these initial disposition choices are not binding. You will sign the official, binding consents later, with the ability to change any disposition choice once you’ve decided your family is complete.
Some parents feel "complete" five minutes after their last child is born, and some parents may still be unsure years later about what option is right for them.
If facing any resistance about deciding on an embryo disposition option, keep in mind that infertility felt like an insurmountable obstacle at times - taller and more intimidating than climbing Denali. The realization that your family-building struggle is over, done, finished, is another layer of acceptance that infertility is part of your past, but not part of your future.
Amazing to consider, isn’t it? Infertility is not part of your future. It’s part of your past. (Even if it doesn’t feel like that yet.)
This is an important decision, so take your time in making it.
Keep in mind, you may feel differently about your embryos after your family is complete. Remain open to the possibility that you may feel differently about your embryos after your child is born. Explore those feelings and reconsider each option.
You're the one who must live comfortably with your decision, and there are some things you can't know until you know - until you hold your children in your arms.
This less commonly discussed way to build a family may seem simple and complicated at the same time. There are many different factors to consider for those on either side of the equation - and this isn't a decision to be made lightly. However, it can be the perfect choice for many families, which is why we feel it's so important to talk about.
If you haven't considered growing your family with donor embryos or donating your own embryos before, we hope that the openness of the two women who shared their experiences will give you a peek into the emotional, yet beautiful process of embryo donation.