When you’re experiencing infertility, the last thing you think about is having more frozen embryos than you actually want to use. Simply having one child come from an emotional and complex in vitro fertilization (IVF) cycle is all that many people can focus on. But the reality is that many individuals or couples who undergo IVF will complete their family and still have embryos left over. What happens then? You may not know from the onset of your IVF procedure what your situation will end up being or the decisions you will be required to make, but there is some initial thought that needs to go into the process before any action takes place. This generally includes any legal contracts that need to be signed.

Upfront, before fertility treatment takes place, most fertility clinics and storage sites require you to sign agreements for consent, stating exactly what you or you and your partner would want in any number of scenarios with any embryos created from IVF. These documents briefly address what you would want to be done with the embryos in the event of divorce or death—of you, your partner, or both. Until an embryo is transferred into the woman’s uterus, individuals or couples can change their minds of what they want to be done. This isn’t something most even think about, but in an unforeseen unfortunate event, this paperwork will determine the fate of your embryos. Once you know the outcome of your treatments, you'll need to decide what to do with any remaining embryos. Fortunately, a number of options exist, including:

1. Keep Embryos in Long-Term Storage

Thanks to the process of freezing, called vitrification, embryos can be rapidly frozen so they don’t accumulate any ice crystals. This leads to better success rates of embryos surviving a thaw. This option usually occurs when an individual or couple is unable to decide on any other option. It’s costly to store embryos, with the average clinic charging anywhere between $500 and $2,000 a year. Depending on the clinic, many will store embryos for up to ten years, but after that, they will often need to be transferred to a long-term storage facility off-site. This is to prevent endless and expensive storage of clients' embryos and is definitely not the best solution for many individuals or couples.

2. Donate Embryos To Medical Research

Another option for remaining embryos is to donate them to medical research. Many times, these donated embryos are used in fertility related research for improving IVF for other patients or training new embryologists. They could also be used for stem cell research for disease prevention or treatment. Some individuals or couples feel like they have benefited so greatly from the science of IVF that they want to give back and help with the progression of research.

3. Disposal of Remaining Embryos

This option means just that. Embryos are taken out of storage, thawed in the lab setting, and discarded respectfully as medical waste. Just as in the option of indefinite storage, this sometimes happens when individuals or couples can’t come to another decision of what to do with their embryos.

4. Compassionate Embryo Transfer

Another option that some people may not be aware of is the process of a compassionate transfer of remaining embryos. A compassionate transfer is a transfer done at a point in a woman’s cycle when getting pregnant would be highly unlikely. The idea is for the embryos to die in a natural environment, rather than in a lab. It’s a decision that has people split—some think it’s ridiculous and a waste of money, while others choose it because they don’t have the heart to just "throw away” their embryos. Some people aren’t comfortable donating their embryos to another family and don’t want to use them for medical research and need an option other than indefinite storage. It’s important to ask if a compassionate transfer is something your clinic would be willing to do.

5. Donate Your Embryos To Another Couple

Sometimes referred to as embryo adoption (although not considered a legal adoption), donating embryos to another individual or couple in need is a great option for helping others achieve a pregnancy when you have completed your own family. It’s a big decision that is likely to come with complex emotions. Some struggle with the idea of embryo donation, as they feel like they are “giving away” their own children. It may not be the option for you if you feel similarly or have a difficult time letting go of control regarding what happens with your embryos. There are many times in the process of donation where you are in charge of decision making, such as your requirements on who your embryos can go to. But some aspects are out of your control, such as how that future child or children will be raised.

Once you sign legal contracts relinquishing your rights, the receiving individual or couple signs their own legal contracts. Both parties then undergo physical and mental health exams, and the receiving individual or couple would then use the embryos by thawing and transferring them, just as in an IVF cycle.

Considerations for Embryo Donation

An embryo donation can be open or closed (just as in an adoption of a child) so you can decide if you want a relationship with the receiving individual or couple and any children they have that result from the donated embryos. There are more adoptive families waiting than there are donated embryos, so there isn’t a concern about not having someone available to take your embryos, but it is better when you have more than one frozen embryo to donate. This is because more people are willing to "adopt" a group of embryos rather than a single one because this offers a higher likelihood of achieving pregnancy.

6. Personalized Disposal

Some people elect to take their embryos home and dispose of them in a personalized or ceremonial way. The concept is similar to disposal at the clinic, but some feel that it helps to accomplish a similar objective in a more meaningful way. This might include burying them in a garden or other similar place that holds meaning for you and your family. This allows for a site of commemoration, which is important to some.

7. Embryo Jewelry

Admittedly a controversial option, it is possible to have your remaining embryos incorporated into a piece of keepsake jewelry. Some may find it comforting to keep their embryos close and to feel like they have a presence in their everyday life. To others, this option may seem simply macabre. There have also been questions raised about the plausibility behind the process of creating embryo 'ash' that is then turned into the jewelry.

There is a lot to think about when determining what to do with your remaining embryos. For some, depending on a variety of factors such as moral and ethical obligations, the decision can be straightforward. For others, the decision process can take months or even years to decide what to do with something you worked so hard to create.

No matter what an individual or couple decides, it’s an emotionally complex decision. Whatever path you choose, be sure it is something that you or you and your partner are at peace with.