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  • Deciding What to Do With Unused Embryos

    Dawn Davenport

    26

    What Options Do you have for Disposing of Unused Frozen Embryos

    I know that the last thing many people at the beginning of their infertility struggles ever think about is the possibility of having extra frozen embryos remaining after they finish treatment. Thinking about this possibility when you are busy praying that you will have any embryos at all, to say nothing of embryos left over when you finish treatment may feel like tempting fate. You should be so lucky to face such a “problem”, right?

    I have the luxury of talking with people who have been just so “lucky”. For some the decision of what to do with their extra frozen embryos is not a big deal at all, but others are surprised by how hard this decision becomes. I think everyone involved—doctors and patients—should consider their options at the beginning, even if you later change your mind.

    I learn best by example and I assume I’m not alone, so Creating a Family is recruiting folks who have faced this decision and will blog about it. If you’d rather remain anonymous, that’s OK too. Here’s the story of Paige, over at Baby Dust Diaries, and how she changed her mind after she had children from the same batch of embryos.

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    When I had my oocyte (egg) retrieval back in 2008 they harvested 29 eggs. Of those 17 fertilized. Of those 12 arrested by day 3 or 5 (stopped growing). That left me with 5. We transferred 2 fresh on day 3 – one was Aellyn. Asher and Boston were both frozen on that same day as 3-day embryos. They grew the remaining embryos to day 5 to see if we had any strong ones. We had one make it to blastocyst which was then frozen on day 5. In 2010 we thawed Asher and Boston, grew them to blastocyst (day 5) and transferred them. We have one remaining embryo in cryopreservation.

    Having extra embryos is common in IVF. …Remember a “fresh” (egg retrieval) cycle is expensive and very hard on a woman’s body. Clinics want to get enough good embryos to freeze some. A frozen embryo transfer (like with my twins) is much easier and much cheaper than going through a full, fresh cycle again. …My point: freezing isn’t a bad thing. It can be a very life-giving technology.

    The problem? There are often left over embryos.

    Your Options for What to do with Your Extra Embryos

    Couples have 4 choices when it comes to these extra embryos.

    1. Have a bigger family than you planned and transfer them anyway. I’ll talk about this below.

    2. Destroy the embryos – they are thawed and discarded as biowaste.

    I include in this category a bizarre practice of some “pro-life” people where they intentionally transfer embryos in a non-fertile stage of a woman’s cycle. This is somehow seen as providing more “dignity” than discarding as biowaste. I feel this is absurd. And embryo implanted in a uterus without a lining has no chance of life. Yes, God creates life but he does it through the reproductive cycle he created. DUH. Using a uterus as a garbage can is just all kinds of stupid. Sorry. I call ‘em like I see ‘em.

    3. Donate them to science.

    Here they are also destroyed (they aren’t grown into some science fiction lab experiment) during use. Uses include training new embryologists and geneticists and stem cell research done to cure diseases like cancer and Parkinson and injuries like spinal column regeneration.

    4. Donate them to another couple.

    Sometimes this is called Embryo Adoption because it can be open or closed but it is not legally an adoption, but a tissue transfer like sperm or egg donation. The embryos are thawed and transferred to another couple hoping to achieve pregnancy. It is illegal in the US to pay for an embryo (or a live child) but sometimes donors are compensated for 1 year of storage costs. There are for-profit donor/recipient matching sites, private arrangements, and most clinics have a donation program.

    …I’d also be remiss if I didn’t mention that cryopreservation costs the couple money each year. My clinic is under $500 but some are as high as $2000 per year.

    Making the Decision

    Trigger Warning: If you are currently struggling through infertility you may want to stop here. I’m going to “complain” about the “agonizing” decision of what to do with my “extra” embryos after having 3 live children. Yeah. I would have wanted to stab myself for saying that just a few short years ago too.

    Our original plan was embryo donation/adoption. We liked the idea of helping another couple struggling as we were through infertility. We imagined having 6 or more extra embryos which would be impossible for us to continue family building with that many. Donation seemed like a wonderful option for us.

    We never imagined two things: One, that we’d be 3 for 4 with IVF! I’ve transferred 4 embryos and had 3 children. That’s just…beyond luck. An embarrassment of riches. I was in tears when we only had 3 frozen because I thought it drastically limited the chance we’d have siblings. Oh to have my problems, right? Secondly, we now have only one frozen embryo.

    How is that a problem? Well, first off, if you are looking for embryo donors you want at least two embryos. The cost alone makes adopting one embryo kind of silly. I’ve found that the general consensus is that people would not want my one embryo.

    More importantly is how I feel about embryos. I think this is personal but, for me, those embryos are my children. I believe life starts at conception. That’s my baby girl in there (no, we don’t know the gender but I hate “it”) and I could never just destroy her, even for science. It feels like a part of my family. I guess if I had 15 embryos I’d feel less specifically attached but I don’t. I have one. One little potential-baby. One brother or sister to Aellyn, Asher, and Boston. I don’t know if God intends us to have a fourth child (and let’s face it to be 4 for 5 is just beyond imagining) but if he does I’m not going to turn away and not try to bring her home.

    My biggest issue is the cost. We are on a tight budget now and the embryo transfer would cost $2000. If we don’t get pregnant I can think of lots of other uses for that money! Using it for the kids I have now. But I have to give her a chance at life. If it’s not meant to be then ok but I can’t not try.

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

    What do you plan to do with your extra embryos if you have them? What option would feel best for you? While Paige didn’t have much use for “compassionate transfer” others might not agree. Check out this Creating a Family show on various thawing and discarding options, including compassionate transfer and thawing ceremonies.

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    P. S. If you are in the process of deciding and need resources to help, consider these from the friendly folks here at Creating a Family:

    Check out Paige’s wonderful blog on infertility and natural living, Baby Dust Diaries. Her recipe for homemade mayo is to die for.

    Image credit: Mike

    06/03/2013 | by Dawn Davenport | Categories: Blog, Infertility, Infertility Blog | 26 Comments


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    26 Responses to Deciding What to Do With Unused Embryos

    1. KJM says:

      Hi Dawn
      I can relate to your post very closely. We also have 1 blastocyst embryo left.
      Our story is we had IVF to conceive our 3rd child. We had a son (5) and a daughter (3) already. But I had opened my heart to a third child and couldn’t let go. It took us 1 1/2 years of trying before we started IVF. We were delighted at our luck of having 2 blastocysts and then a pregnancy on our first cycle. We now have another son (16 months)! He is simply adorable. BUT, then a dilemma has subsequently occurred as we have 1 blastocyst frozen….. waiting…. Every time the 6 monthly invoice arrives for continuing freezing our dilemma that we have put aside rears its ugly head.

      My husband adamantly doesn’t want 4 children, but like you, I see the blastocyst as more than a bunch of cells. My husband feels the stress and financial cost of having 4 children is not the right thing for us to do. He was happy with 2 children to begin with, and gave in to let me try to have a third. Having 4 children was never in our life plan. I am also turning 39 next month.

      However, I simply could NOT sign a form requesting my blastocyst be disposed of, research, or donated to someone else, as I I see that as my possible child and/or my children’s sibling living with another family – the child we gave away….

      Being pregnant with a 4th child at 39 scares me and the thought of childbirth again – OMG, but I am SO frustrated and confused. I don’t want to live my life with regrets and feel that if I didn’t give this blastocyst a chance to see if it is a survivor, that this is something I would regret. I have no intention of conceiving a child naturally or of doing another IVF harvest cycle, but feel we have created something and we need to give it a chance, even if I don’t want to put my body through it. My husband just gets mad when I talk about it. Any advice on how to deal with my dilemma would be greatly appreciated. What happened to your remaining blastocyst Dawn? Any advice on how to talk to my husband about it?

      • Dawn Davenport Dawn Davenport says:

        KJM, I am fortunate to never have been in your position, but I do feel for you because I think it would be a hard decision. I’ve talked to many people in the process of making this decision and there is no one “right” answer. I think it would help you to talk with people who are either in your position or have been in your position. I suggest you join the Creating a Family Facebook Support Group (https://www.facebook.com/groups/creatingafamily/) It’s a closed Facebook group so that only those in the group can see the posts. A number of people (actually quiet a few) have faced this decision.

    2. HeatherDH says:

      My husband (48) and I (41) have two children – a son (6) who we had naturally, and a daughter (2) we had through IVF. We had two IVF cycles and have one embryo in cryopreservation. I have been torturing myself about what to do with that one frozen embryo for the past 3 years (I started torturing myself about it as soon as it was frozen – only one!). My husband has different feelings than I about what to do with the frozen embryo. Because of his age he feels that he is done having children and he is open to donating it to another couple or ‘destroying’ it…(I hate the terminology). I am stuck in a loop. I haven’t been able to sign the paper to have it ‘destroyed’, so I try to convince myself to do ‘the loving thing’ and donate it to another couple (at least it would have a chance at life, right?) but everything within me revolts against that decision – I don’t think I could live with constantly wondering about that child I ‘gave away’. I’ve tried very hard to examine my thoughts and feelings on this, but they just aren’t budging – when I think of giving the embryo away I just want to keep it, and then I am back at square one – with a partner who does not want more children. One thing I feel certain of, this is not a one-size-fits-all decision and those who have wanted to tell me what I should do are never the ones who’ve been in this position themselves. I feel this difficult decision is the cost of being able to use science to take fertility into our own hands, something I am forever grateful for every time I look at my little girl, something I would do again in a second despite the torture of this decision. I wish everyone well with their choices, I think we all have to make the one that is right for us, and find peace with it as much as possible.

      • Dawn Davenport Dawn Davenport says:

        Heather, you summed up the agony of the choice and decision far better than I have ever been able to. Thank you.

    3. Toni says:

      I have a beautiful 4 yr old girl from my 1 try at IVF. I also have 3 frozen embryos that I am now considering what to do with. The father and I are divorced and I am engaged to a wonderful man that cannot have kids. I have stage 4 endometriosis and have recently been diagnosed with a “frozen pelvic”. Basically, I don’t think transferring them are an option but I’m not sure what else to do with them. I love the idea of giving them to a couple in need.

    4. Natalie says:

      How do I donate to a couple and not a anonymous person. I wouldn’t want to have a relationship but I would like some sort of contact. Do people do this? Like open adoption?

    5. Alexandra says:

      I have PCOS and overstimulated even before surgery. However, it was too late to turn back and so 47 eggs were retrieved. Around 30 fertilized but a few had two sperms and aren’t viable. Then we were down to 24 and prayed for maybe 5 or 6 to make it. We have 23 blastocysts all A or AB quality. We only lost one! The blessing and miracle is amazing AND heartbreaking. I’m 28 and I don’t know what in the world to do. I pray the first transfer takes with all my heart but I have 23 children waiting for me and I can’t possibly have them all. I know it will all work out. Heck. None of them could implant. That’s a possibility. I just feel so drained. And we are going through an adoption of our foster son. Sometimes there are no easy answers.

      • Dawn Davenport Dawn Davenport says:

        Alexandra, take it one embryo at a time. Transfer and then see. It is possible, as you say, that implantation may not happen with the first. You will likely have this issue to face, but wait until after your family is complete and then see how you feel.

    6. Sharon says:

      We are having our embryo transfer tomorrow day 5. I do not know what to do. As of day 2 we had 8 and will not know until tomorrow how many we have. I do not fill comfortable discarding our baby embryos, but we don’t have the $1500.00 to freeze them either. On top of this we do not want to go through IVF again. We scraped by every penny for this one cycle and emotionally after 7 miscarriages my husband and I can not handle trying to get pregnant again. This took several years of getting up the nerve to try just this one time. We are definitely open to donation, but it’s paying the 1500.00 for it that is the problem. Any advice?!?

      • Dawn Davenport Dawn Davenport says:

        Sorry, I have no great advice. I would try to find a way to pay for the freezing to preserve your options. If this transfer does not work, you may want the option to try another frozen embryo transfer after some healing time has passed. Or you may decide to donate to another couple.

    7. Amy says:

      Thank you so much for this. We are making a decision in the coming weeks our 2 “frozen babies”….heart wrenching to say the least.

    8. Paige @ Baby Dust Diaries says:

      Thanks for reposting! I hope it gets a dialog started!

    9. Swen says:

      Thank you for this. I don’t think any of us in this position ever thought we’d be here or thought how hard this decision really is!

    10. Lucy says:

      As of now, I have two children, and four frozen embryos. Separated from their
      dad,which makes things more complex. I am 53 and despite my age and
      not having a lot of money, I am considering transferring them. It is a dilemma.
      I feel responsible for them and do not want to abandon them, whether by discarding
      them, donating them to science or other parent. I feel I need to complete this whole
      process, and do it respectfully. It has taken so many years, money, fraught emotions,
      hard decisions, that I don t want to close this chapter lightly.
      May God show me the way, for the best of everyone.
      Best wishes to those who are agonising over this difficult decision and have a
      reonsibility to honour.

    11. Catherine Tucker says:

      Thanks Paige for sharing your story.

      Dawn: I’m typically hearing that there are way more prospective parents than available embryos. In fact, even clinics with very active embryo donation practices, such as EDI in Florida, have to unfortunately turn away some patients. I also have never heard of a clinic with an oversupply of available embryos, but I wouldn’t be at all surprised if the situation is different in 5-10 years given the rapid advancements in technologies that allow for more viable embryos to be created and frozen per IVF cycle as well as the increased availability of donor egg cycles. Your readers might also find informative my blog post that discusses some of the things I advise my clients to think about when making these kinds of decisions: http://tuckerlegal.com/leftover-embryos/

      • Catherine, thanks for the great blog! I haven’t heard of a clinic that has excess embryos, but I have heard from a few adoption agencies with embryo donation programs that they have plenty of embryos. Not sure how universal that is.

    12. Dawn Davenport Dawn Davenport says:

      I hear varying reports on whether there is an adequate supply of embryos or whether they are scarce. Some clinics and agencies I speak with say they have a balance between embryos and intended parents, while others say they are actively recruiting families to donate embryos. I have not heard of anyplace that has many more embryos than they have people who want them. What is everyone else hearing?

    13. Whole Child says:

      I am a nanny for twins conceived through IVF. Their parents have 3 embroys left, but are not sure that they want more kids. I was talking with Dad about embryo adoption and he doesn’t feel comfortable with the idea of his genetic children “out there” for someone else to raise. He feels responsible. It is a tough call. I have no judgment either way b/c I have seen families fall apart b/c they had kids they couldn’t care for…but I’ve seen the other side of people desperate for kids. I don’t think embryo’s are in such high demand that people are not becoming parents b/c they can’t find the embryo to implant, but I don’t know the exact numbers.

    14. Anonymous says:

      in the current environment, embryos for donation are scarce.If they make it to blastocyst, they will be in high demand even if only single embryo.

    15. M says:

      Paige, thanks for sharing your perspective, and good luck with your transfer!

      I’m interested in embryo adoption and surprised to read that there’s little interest in adopting just one. Of course there are significant costs involved, but there can also be issues with carrying and raising multiples. Being single makes me more cautious about those issues. This post gives me hope that a single-embryo match might be out there somewhere.

      • Dawn Dawn says:

        M, you raise a really good point. Many people are wanting a couple of embryos (often frozen in the same straw) to allow for the fact that some might not survive the thaw or might not grow to day 5 blastocyst (if that is the protocol being followed). However, that might increase the odds for someone who is willing to take the “risk” with just one. Another thing that increases the odds of getting embryos for a donation is to accept those embryos that are not rated quite as high. Again, some people aren’t willing to run that risk. I wish you great luck.

    16. Lucky says:

      I disagree that embryos are scarce. I know SEVERAL people that posted recently that they were searching for embryos and found them within a month. Also, with the traditional slow freezing, they often do not survive thaw. My friend had 12 donated, and the first two did not survive. However, vitrification is a different story. Successful thaw is something like 90%.

      • Dawn Dawn says:

        Lucky, you’re right that vitrification has completely changed the landscape of cyropreservation. I’m curious about where the people found their embryos quickly. Was it at an agency or a clinic?

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