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Embryo Donation: The Science and Stories Behind the Choice

August 31st, 2020 | 13 min. read

Embryo Donation: The Science and Stories Behind the Choice
Lisa Rosenthal

Lisa Rosenthal

With 30+ years experience in the fertility field, as well as navigating her own infertility, Lisa has dedicated her life to advocating for and supporting those struggling to grow their families. Her work includes serving as Illume Fertility's Patient Advocate, Strategic Content Lead, and founder of Fertile Yoga, as well as advocating for those with infertility at RESOLVE and other organizations.

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Maybe you can relate to the following scenario...

A couple has unfortunately experienced the emotional roller coaster of fertility treatment, but now, they have the family of their dreams. In the process of building their perfect family, they created a set of embryos. They used some of them but not all. What can the couple do when they consider their family to be complete but have embryos “leftover”? What are the options?

The first part of this blog will be devoted to answering those questions and discussing basic ART (assisted reproductive technology) sciences. It will be a very clear explanation of the choices individuals have when faced with a surplus of embryos after completing their own family building.

The second part of this blog is a true love story of one family completing their journey and donating their extra embryos. In that offering, they help make another brand-new family.

What Does “Embryo Disposition” Mean

Embryo disposition is what happens to excess cryopreserved (frozen) embryos once a person or couple has completed their family and decided to not have any more children via assisted reproductive technology. 

Using a vastly simplified explanation, many people undergo IVF (in-vitro fertilization), where eggs are retrieved, sperm is added, and embryos are then developed. (Unused, excess, spare, and leftover are other terms used for the embryos that are left after a family is completed.)

Finished Building Your Family? How to Decide About the Other Frozen Embryos

Embryo Cryopreservation Facts

  • In the United States, the estimate of frozen embryos hovers at about one million and is rising.
  • Before undergoing IVF, preliminary decisions need to be made concerning any excess embryos, but final determination happens later, before actual disposition occurs. In other words, you aren’t locked into a decision before IVF takes place.
  • The cost of storing or keeping embryos cryopreserved (frozen), ranges between $350-1,500 per year.
  • Technology is not infallible. Therefore, there have been situations where embryos have been inadvertently destroyed from thawing/power outages/generator failure.
  • Even after two decades, frozen embryos have produced healthy pregnancies and babies.

Embryo Disposition Options

There are 4 possibilities for choosing what to do with an embryo:

  1. Continue storing the embryos.
  2. Donate the excess embryos to science (embryos are used for research and will not be used to establish a pregnancy).
  3. Donate the embryos to another person or couple.
  4. Disposal of the embryos (embryos are thawed and discarded).

RESOLVE: The National Infertility Association offers an expanded description of each of these choices. For more information, click here.

Embryo Donor Shares Her Process About Her Decision

And so, an unconventional love story begins as one woman’s fertility journey ends.

A woman who completed building her family, takes us through the process, step by step, answering even the most challenging questions, none harder than “do you consider the embryos to be your children?” She was a Ladies Night In and Fertile Yoga participant from years ago, and now participates with the RMA of Connecticut Mommies After Infertility group.

She’s 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. 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.

Please be aware that these initial consents for embryo disposition are not binding. You will have the opportunity to revisit your decisions and change them when you are finished family building.

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 a couple. The idea of donating to a couple 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 me 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. 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 "donating to science" was an easy decision because there wasn't any real emotional tie to it. I have a close friend who was going through treatments due to a lack of eggs, and her chances were quite slim to be able to have a family. We could make a direct impact by donating to someone, rather than an indirect impact by machine calibration.

Q: Have you had any thoughts or feelings since your initial decision? A change of mind or heart?

A: Our only change of mind or heart was that we decided to help a couple/individual rather than to science. We saw more positive potential.

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's 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 any shift in your feelings about the remaining embryos?

A: After completing my family, I knew I wanted to give someone 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 to be transparent about things like that, especially when there are DNA programs like 23 and Me. I couldn't imagine my daughter finding out she has a sibling through something like that and feel 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 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 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 all senses 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 - my child from the same batch, as well as my other child who does not have that 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 do consist of both your DNA and your husbands?

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 may be in a different situation, and 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 and hold on to some hope!

Q: What would you like to say to any children resulting in your donated embryos?

A: Your parents are doing the best they can. 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 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. I would want to make sure they understood the magnitude of opening that door. Be sure that other children want 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 a CHANCE to have a child. There are no guarantees. We went through several rounds of IVF, and thankfully we were able to conceive. For those who are not 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?

Embryo Recipient Shares Her Joy in Receiving Embryos

*Trigger warning: suicide*

Coming to the decision to accept a frozen, donated embryo was another thoughtful decision, as you will read below. Accepting and loving the child from that embryo, was as simple as it could possibly be. Another Ladies Night In, Fertile Yoga participant shares her story about how her family expanded because of another family’s generosity.

Q: How did the you start off with trying to build a family?

A: So, this all starts 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 RMA of Connecticut for testing to just "get a handle" on my ovulation. Ha ha! So, as it turns out I am very normal in that I am aging and my ability to conceive is greatly reduced. Yay me! It was recommended that we go straight to IVF (my insurance covered it 100%...color me lucky...right?!?). I was a non-responder the first round. In my second round, five eggs were retrieved, three fertilized, none made it past day three. It was in the start of my third attempt that we had to cancel the round. My husband had a breakdown and later on committed suicide. Now I was left without a partner but still wanting more than anything to be a mother. Several months later I walked back into RMA of Connecticut and had a very straightforward conversation with my doctor.

Q: When did you first hear 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 have a baby that way." Nobody says...I want to wait until I am almost out of eggs and try and try hoping for the magic positive pregnancy test that at best has a 12% chance of happening for a younger woman, any given month. For that matter, nobody says they want to become so well versed in infertility that they know the stats. Personally, I would rather be keeping track of the Yankees stats than when I am ovulating and what my blood levels are and how much more time before I am out of time. As I thought about it more and more as a viable possibility for me as time went on and things weren't going the way they needed to go.

Q: What did you consider when making the decision to do embryo donation? Any feelings you had 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 look at an egg donor. I had become comfortable with the notion that the child I carried might not have my DNA.

So, embryo donation? It 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 heartbeat for the first time.

Q: What did your pro and con list look like when you realized you might be a candidate for embryo donation?

A: Pro - baby, chance to carry the baby, opportunity to give birth, no man needed.
Con - didn't have one

Basically, 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 WANT TO BE A MOM. I want to carry a baby and give birth. I want to be a mom. I was not giving up on this. One way or another...I WAS GOING TO BE 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 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 sharing 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 ordered him from a catalog.

Q: Who did you share the information with about your embryo? Were they supportive of your decision?

A: My family and close friends were aware of my decision...and the Ladies Night In group. EVERYONE was very supportive.

Q: Immediate thoughts and feelings after your child was born?

A: Who can remember? LOL. 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 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...she 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.

The social worker for the program told me to always be honest with him. I know one day he will probably want to find his sister (yes, he has a sister who is a few years older). Things like almost guarantee he will find his genetic relatives one day, if he wants to. I would love to say I will be okay with that...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.

Considering All the Options When Deciding on Embryo Disposition

Making the important and permanent decision about what to do with excess embryos will be yours to make when your own family building is complete. Yes, you will sign consents at the time of your IVF cycle, but these 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 in their arms, and some parents may still have questions years later about what option is just right for them.

In facing any resistance about deciding on an embryo disposition option, one may do well to keep in mind that infertility was an obstacle that at times, may have felt taller and more imposing than 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 your past.

This is an important decision; take your time in making it.

It’s important to remember that whatever you may have previously decided about your excess embryos doesn't mean you can't change your mind. You may feel differently about your embryos after completing your family. Explore those feelings and relook at the options. You're the person (or people) who must live comfortably with the decision, and there are some things you can't know until you know, until you hold your children in your arms.

Building Your Family Through Embryo Donation

And a final note to those considering the embryo donation program as a way to have a child: this is a lesser-known way to build a family. If you haven't considered it before this, hopefully, the openness of these two women in sharing their experience will give you a peek into the inner, emotional work of this embryo donation.

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