For some reason, and I’m not really sure why, an unusual number of infertility professionals wanted to talk with me at this year’s American Society of Reproductive Medicine (ASRM) conference about embryo disposition options. It really was a bit uncanny. Creating a Family has the most extensive resources online for all the embryo disposition options (donate for family building, thaw and discard–including compassionate transfer or ceremony, and donate to research), and I did extensive research and interviews for a book proposal a couple of years ago on how people decide what to do with their unused frozen embryos, but honestly, I’m not sure that was the reason that the conversations kept coming up. Some of the folks knew about our resources and my research, but some did not. It felt like one of those coincident things, except I don’t completely believe in total coincidences, so I’m not sure what to make of it.
Whatever the reason, I’m thankful more attention is being focused on this issue, especially by the medical community. No one knows exactly how many embryos remain in cryopreservation in the US, but the last estimate over 10 years ago was 500,000. The estimate I was working on when I was researching the book was over a million. That number is also outdated now.
One of the things that really struck me with many of these conversations at the ASRM conference is the disconnect with many in the infertility medical community with why deciding what to do with unused embryos is a difficult decision for some patients. When one reproductive endocrinologist, who I really like, heard me speak on compassionate transfer (transferring the embryos to the vagina during a non-fertile time), he shook his head and said he’d never understand people who were in such denial. Another RE piped up that no infertility clinic should allow such “nonsense”.
To be fair, many couples/singles do not struggle at all with the decision. Once they no longer want to use their remaining embryos, they smoothly move to one of the options and don’t look back. However, for others it is a very hard decision, and many are caught totally off-guard by this difficulty. They either thought they knew what they would do, but changed their mind once they had children, or they never gave embryo disposition much thought until they realized they were finished with their family (or wanted to stop trying) and had extra embryos remaining.
I spoke with a couple during a consult yesterday that were trying to decide on whether to move to adoption or keep trying with fertility treatment. Both were ready to move on, but they had five embryos frozen. The wife knew in her heart that their existence would continue to weigh on her, and that no option other than giving them the possibility for life would ever feel comfortable. Donating to another couple felt odd, when they could just as well transfer to them in another attempt. And yet, she was ready to be finished with treatment.
I spoke with another family this fall wrestling with donating their four unused embryos to another couple or to research, but neither option felt right. A month before that there was the couple trying to decide how much contact to maintain with the family that had been created from their donated embryos and what to tell their children. And then there was another family that felt complete with their boy/girl twins, but had decided to thaw their remaining embryos for a transfer, even though they were very torn on whether they wanted more children. As I tried to explain to the reproductive endocrinologists I spoke with at the conference—it’s complicated.
Creating a Family is dedicated to providing unbiased medically accurate information (see links below). We don’t try to push one option over the other, but we do want to spread the word that this is something that should be thought about BEFORE the embryos are created. Much of this work needs to be done with the medical community to encourage them to educate patients before IVF to get them started in the thinking process.
Have you faced this decision? Was it an easy decision for you? In keeping with my appreciation of been-there-done that advice, I’m looking for people who either have or would be willing to blog/write about the process of deciding what to do with the embryos they still have frozen. If you know of anyone, please let me know either in the comments or by email (dawn at creatingafamily dot org). Thanks.
P. S. If you are in the process of deciding and need resources to help, consider these:
- Donate to another person for family building
- Donate to research
- Thaw and discard
- General resources for exploring options