Have more kids or stop? What to do with your extra embryos?
In my time as a fertility doctor, I have seen mostly joy, a little sorrow and a spectrum in between. I have been lucky enough to help build many families over the years. When patients come to my office, they are hopeful to leave with the promise of at least one baby, but with the hope of more to come.
It’s true. Having children really changes your view on these things.– Steve Jobs
When you come to one of the many moments in life where you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s days with a sated joy, a joy unknown to me in all my prior years, a joy that does not hunger for more and more but rests, satisfied. In this time, right now, that is an enormous thing.– Paul Kalanithi, to his one-year-old daughter, in When Breath Becomes Air
With an increasing number of in vitro fertilization (IVF) cycles being performed (particularly in Ontario, with the help of public funding), we are finding that more patients are opting for IVF sooner, and at younger ages, and they are often opting for single embryo transfers to avoid the risk of multiples. This has resulted in an increase in the number of frozen embryos in many IVF clinics all over the world. Over 400,000 embryos are in storage in the United States, and over 15,000 are in Canada, many of which will never be used.
This begs the question, What do you do with extra embryos after you have completed your family?
1. Have more kids!
I see many patients come back for their third and fourth babies just to use up their frozen embryos. While children are amazing, more children can take a financial and emotional toll on any parent or family. Carefully consider these aspects, as well as medical concerns that come up with increasing age at conception and during pregnancy, prior to embarking on frozen embryo transfers just to use surplus embryos.
Often, medical clearance by an obstetrician, especially in the case of a complicated pregnancy or delivery in the past or maternal age over 40, is warranted. Consulting a social worker might be helpful when you’re deciding whether to expand your family and to help identify any potential life stressors that could arise when having additional children.
2. Donate embryos to research
The field of assisted reproductive technology (ART) is constantly evolving, and we as reproductive health practitioners are always looking for ways to improve IVF success rates. Research on embryos and their makeup can help us determine what factors optimize pregnancy rates during IVF, with respect to embryo genetics, culture media and lab conditions.
Ask your fertility center about ongoing research studies and how your extra embryos could contribute to furthering research in these areas. Embryos donated for research are always de-identified, and no personal qualifiers are included when genetic material is used for research.
We always ensure that patients have specifically consented to any research done with their donated embryos, and your fertility doctor can always sit down and discuss research projects in detail, so that you have all of the information necessary to make the right decision for you.
3. Support an embryo donation program
Some clinics have embryo donation programs, whereby a patient can provide their embryos either as anonymous or directed (i.e. known) donors to a couple who are trying to conceive. The embryos and prior transfer outcomes must fulfill certain requirements in order to be eligible for donation.
Certainly, many patients would benefit from receiving embryos to help them start a family. Speak to your clinic about the possibility of this option if it sounds like a reasonable choice for you and to see whether it has an embryo donation program.
4. Hang on to the embryos longer!
No one knows what the future holds. Technology is forever changing. Stem cell research is rapidly evolving. Embryos can remain frozen for 20+ years, likely longer, and still be viable upon thaw. That being said, some countries are considering imposing restrictions on how long embryos may remain in storage. This stems from the fact that there are many, many unclaimed embryos in the world that will likely never be used.
As always, good counselling and a discussion with your support network (whether your partner, family or friends) and your fertility doctor are important in this process. This decision is not to be taken lightly.
I am often reminded of Steve Jobs and Paul Kalanithis’ reflections on children. Our young ones are precious and a gift but also an incredible responsibility. Take the time to think about your options with frozen embryos and to make the decision that’s right for you.