What Should I Do with My Unused Embryos?

My husband and I have three fertilized eggs on ice, and we’re paralyzed.

Credit...Armando Veve

This story was originally published on Nov. 22, 2019 in NYT Parenting.

In the bowels of Midtown Manhattan, a trio of embryos sit in a vat of liquid nitrogen. They’re the genetic siblings of my sons, Jack and Charlie, the frozen fruits of an I.V.F. cycle completed in 2016 — and I have no clue what to do with them.

These embryos — created from my eggs, my husband’s sperm and a lot of our money — represent a tiny fraction of the estimated 620,000 cryopreserved embryos in the United States, according to the Health and Human Services Department. Many will be implanted in the hope of making more babies. But some remain stuck in limbo, dependent on people who are done building their families and now have an agonizing decision to make.

For those like me who are definitely done reproducing (two kids is plenty for us, thanks), there are three options: preserve, discard or donate. “If there’s any chance they would want them in the future, it’s better to hold onto them,” says Dr. Briana Rudick, the director of Columbia University Fertility Center’s Third-Party Reproduction Program, of a patient’s option for long-term preservation. “You don’t ever know what life is going to bring you.” Some of her patients have donated embryos to friends — or returned for them after the loss of a child. (Cryopreserved embryos seem to be viable for decades. In 2017, a healthy baby girl was born from an embryo that had been frozen for 24 years.)

[Learn more about I.V.F. and how to bring down the cost of treatment.]

Another option is to thaw and discard them. Some patients find relief and closure this way, but I’m not sure I can bring myself to destroy our hard-won embryos. “Discarding seems so wasteful, when there are so many people who are in such need,” says Dr. Craig R. Sweet, the medical director of Specialists in Reproductive Medicine and Surgery in Fort Myers, Fla., and the founder of Embryo Donation International, one of a small handful of non-faith-based and full-service embryo-donation programs in the United States.

The more I research embryo donation, the more appealing it becomes. Perhaps because I vividly recall the agony of infertility, I’m attracted to the notion of helping others surmount it. But apparently I’m an anomaly. ReproTech, one of the nation’s largest fertility cryopreservation facilities, reports that only 1 percent of clients who pulled embryos from storage last year did so to donate. “It’s a hard mental decision,” says Brent Hazelrigg, ReproTech’s chief executive. “I have two children myself. I just really can’t imagine giving up embryos that are their siblings, my children, to someone else to raise.”

A potential fourth option, donating to science, reveals a dead end. Only a handful of programs in the United States, like the University of Michigan’s, accept donated embryos for research, and only those identified as carriers for genetic disease. “Most of the embryonic stem-cell facilities have a bank of embryos and cell lines started, and they’re just really not in need of new embryos,” Hazelrigg explains.

With little guidance and no easy answers, many patients have created their own alternative: They’ve simply stopped paying for storage. This can certainly ease a financial burden, as storing embryos at a fertility clinic can cost up to $200 a month. But for some it may relieve an emotional burden too — that of having to decide. “A lot of people abandon their embryos — you can’t reach them,” says Dr. Zaher Merhi, the director of research and development in I.V.F. technologies at New Hope Fertility Center in Manhattan.

Estimated embryo-abandonment rates in the United States range from 1 percent to 24 percent. This discrepancy is due, at least in part, to dissent within the industry on the definition of “abandonment.” The American Society for Reproductive Medicine defines it as five years of no contact despite repeated attempts, but some clinics consider embryos abandoned after as little as 90 days of nonpayment for storage. “A lot of clinics get stuck with patients not paying their bills, yet it’s costing a lot of money,” Dr. Merhi says. “You need staff, you need electricity, you need to make sure the liquid nitrogen is good. It’s really a problem.”

Almost all clinics counsel I.V.F. patients about their disposition options up front, asking them to sign a consent form about what will be done with their embryos in the event of death, divorce or nonpayment. Yet even with protections in place, clinics still shy away from actually thawing and destroying embryos. “What if a patient tries to sue me, and says, ‘Oh, you discarded my embryos, and I didn’t tell you to?’ ” Dr. Merhi says.

Legally, unused embryos can also become a sticking point in family court. “Where I see this issue of embryo disposition coming up a lot, ironically, is in my divorce cases,” says Stephanie Brinkley, a lawyer specializing in assisted-reproduction and family law and vice-chairwoman of the American Bar Association’s Assisted Reproductive Technologies Committee. “The wife wants to keep them. Maybe she’ll use them someday. And the husband says, ‘No way, because I don’t want to be on the hook for child support.’ ”

What to do about this growing problem? Although there are no easy answers, some experts have proposed partial solutions, like passing federal laws limiting embryo cryostorage (Britain has a 10-year cap). Dr. Merhi suggests creating fewer embryos in the first place by stimulating the ovaries into producing fewer eggs in a cycle. And Dr. Rudick proposes genetic testing. “I think it does make it easier on someone’s mind-set to say, O.K., we did testing for this embryo that tells us there’s a very low chance this would ever become a live birth, so maybe we don’t feel as bad discarding it,” she says.

And while everyone I have talked to agrees that clinics can help by counseling patients on their options, Dr. Sweet emphasizes sharing the responsibility for decision-making. “It’s not just my program’s responsibility,” he says. “The patients have a responsibility, and as difficult as it is, they need to take a deep breath, learn what their options are and make decisions — even when they’re uncomfortable.”

Yet for me, this far surpasses discomfort. I see it as a life-or-death decision, which makes it nearly impossible to make. My husband and I keep returning to donation, compelled by the idea of paying forward the gift that I.V.F. gave us. But Dr. Rudick’s words haunt me. Nothing can make up for the loss of a child — but in a worst-case scenario, these embryos could represent a chance to rebuild our family.

And so, like many others, we’re keeping our embryos on ice — not just pausing their chance at life but freezing time on the need to decide.

Anna Hecker is a writer living in Brooklyn with her husband and two sons. Her young adult novel, When the Beat Drops, is out now.