How Do You Decide What To Do With Extra Embryos After IVF?

As we transition from the end of one year to the beginning of another, I am reminded of the patients who have shared with me how emotionally difficult it was to make a decision about what to do with their extra embryos after they had completed growing their family.

Although many people don’t have extra embryos or don’t have difficulty making decisions about what to do with excess embryos, for some the decision is a dificult one and as a result they continue to pay their annual storage fees in order to delay decision making. But there are actually several strategies that patients may consider to help with decision making in these situations. And several of these strategies begin before even starting IVF!

How Should I Think About My Embryos Before I Begin IVF?

It is often helpful for patients to have thoughtful conversations with themselves, their loved ones, and their fertility doctors before starting IVF about any emotional, ethical/moral, and/or religious concerns they have about having excess embryos at the end of IVF. Some patients may also choose to talk to their fertility doctor about the pros and cons of only fertilizing some of the retrieved eggs and freezing the extra eggs as just eggs. This way, they have fewer embryos at the beginning and end of IVF and if needed in the future, they can have some of the remaining frozen eggs thawed and attempt to try to use them to make more embryos. For many people it is easier (though not necessarily easy) to make a final decision about extra eggs v. extra embryos.

Many patients have also shared that finding out the sex of their embryos can make them more emotionally attached to the embryos. They talk about how once they know the sex of the embryos; they start to imagine them as potential future cute little boys or girls and this can make it harder to make a final decision about not using the embryos. Because of this, some patients who have their embryos genetically tested choose to only find out the sex of the embryo being transferred and ask not to be told the sex of the extra embryos as a way to help with final decision making.

Will I Change My Mind About How I Feel About Embryos?

Other patients talk about realizing they are becoming more emotionally attached than they thought they would be after they have a baby using IVF or as treatment continues. Or they struggle to make a final decision because they are saddened that they are not going to have another child.

Patients may benefit from ongoing conversations with their partner or others in their support system about their thoughts and feelings about their embryos and completing family building throughout the course of fertility treatment (and until family building ends) to help them prepare for a final decision. Checking in with yourself and your partner (if you’re partnered) after you have your first baby from IVF may be a particularly important time to talk about your embryos as some people become more attached to their embryos after having a baby.

What is Embryo Donation?

When you have extra frozen embryos that you do not plan to use, you may consider embryo donation. Embryo donation involves donating your extra embryos to research or to another person or couple. If your embryos are being stored in your clinic or in a cryopreservation facility, either organization may be able to talk to you about research options available for embryo donation (e.g., https://www.med.stanford.edu/hesc/donations/tissue.html). If you would like to donate your embryos to another person or couple, your IVF clinic or cryopreservation facility (e.g., https://reprotech.com/embryo-donation-disposition/) should also be able to direct you to embryo donation agencies with whom they work. Openness in embryo donation is generally encouraged and you can talk with embryo donation agencies about getting to know the person(s) who will use your donated embryos before the embryos are donated. Donating your embryos to research or to another person generally does not cost you any money.

What Do I Do With Extra Embryos After I’m Done with IVF?

Some patients have difficulty making a final decision about extra embryos because none of the traditional options (like discarding the embryos, donating them to research, or donating them to another person or couple) feel right to them. These patients may consider other options such as asking their clinic if they can take their embryos home and create a personal grieving ritual experience such as placing the embryos with a letter or a poem under a newly planted outdoor bush or tree so that each year as the leaves or flowers come and go on that plant they are reminded of and can engage in thoughtful reflection of their experience.

If You are Struggling to Make a Decision about Embryos

Finally, for all those who struggle to make a final decision about embryos, speaking with a mental health professional like me who has specialty training in reproductive medicine can often help with the final grieving and decision-making process.