Dec. 4, 2008 -- Couples who have unused and unwanted frozen embryos as a result of infertility treatment often feel conflicted about what to do with them, with disposal and donation frequently seen as unacceptable options.
This is the finding from the largest survey ever conducted examining fertility patients' attitudes toward their stored, frozen embryos.
There are about half a million such embryos in storage in the U.S. The survey revealed that many patients remain in limbo about what to do with their embryos once they have no more need for them.
One in five patients who said they had completed their childbearing indicated that they were likely to freeze their embryos "forever," while 36% said they were likely to thaw and dispose of the embryos.
And just 34% said they were somewhat or very likely to donate the embryos for use by other infertile couples.
The survey was published today online in the journal Fertility and Sterility.
"The prevailing view in the philosophical debate about this issue is that patients who care about their embryos will choose to donate them to another couple, but this is not how patients often see it," Duke University Medical Center ob-gyn and bioethicist Anne Drapkin Lyerly, MD, tells WebMD. "Patients may care very much about what happens to their embryos, but that doesn't meant they want them to become children."
Donation for Research Preferred
For couples facing infertility treatment, the question of disposing of frozen embryos may either never come up or be far down their list of concerns.
But once treatment is complete, patients commonly face the decision of what to do with the frozen embryos they don't plan to use.
One study shows that as many as 70% of patients with frozen embryos who consider their families complete continue to pay annual storage fees for five years or longer.
The newly published survey included more than 1,000 patients treated at infertility clinics across the country. Four out of five patients had at least one child at the time they completed the survey, and 44% had two or more children.
The survey presented four choices for disposing of embryos: thawing and discarding; donation to an infertile couple; indefinite freezing; and donation for research.
Two out of three patients (66%) who wanted no more children said they would be somewhat or very likely to donate the embryos for research. That was almost twice as many as said they might donate the embryos to infertile couples.
Donation for research was the most widely accepted option for disposing of frozen embryos, but Lyerly points out that many patients don't have this option or don't know that they do.
"Many centers don't make available all the options for disposition," she says. "Even in places where embryo research is not conducted, it is possible that embryos can be transferred to another center, yet this might not be discussed."
'Not an Easy Decision'
Lyerly says she hopes the survey findings will encourage more in vitro fertilization (IVF) physicians to discuss embryo disposal options with their patients before decisions need to be made.
"We aren't advocating that patients make the decision up front," she says. "But there does need to be a discussion about options and the fact that they are probably going to have to make a decision at some point."
Marti Bailey of Knoxville, Tenn., agrees.
Bailey was in charge of public relations for Knoxville's National Embryo Donation Center before giving birth to twins from donor embryos eight months ago.
Even though she is a passionate advocate of embryo donation for use by infertile couples, Bailey says she understands the conflicted feelings patients have about donating their unused frozen embryos.
Her donation was open, meaning that she keeps in touch with the Connecticut couple that provided the embryos that produced her baby daughter and son.
"This is not an easy decision," she says. "When I worked at the center I saw firsthand how little patients and even doctors and counselors knew about the options. It is important for these professionals to talk to patients about this issue before decisions have to be made."