What to do with leftover embryos: Navigating decisions after IVF

For almost anyone navigating IVF, a perma-feature of the process is difficult decisions. Encountering them, making them, and finding peace in the aftermath. 

Depending on your situation, one of the most emotional and often unexpected choices can hit after treatment, when you’ve decided to stop IVF: what to do with leftover embryos. This may be because your family is complete, or IVF with these embryos is no longer in your plans. 

These embryos, carefully created and preserved during the IVF process, hold immense potential and deep personal significance, making the decision of what comes next a uniquely complex one.

Here, we’ll unpack the key options available, answer your common questions, and provide pathways to help you put your wishes into action – all while adhering to up-to-date national guidance.

Understanding frozen embryos and the choices available

First, it’s essential to understand why leftover embryos exist. During IVF, fertility specialists often create and freeze multiple embryos to increase the chances of successful treatment. If your family is complete or you’ve decided not to pursue further treatment, but still have embryos remaining, what should be done with leftover embryos?

It’s crucial to state here that at TRB, we rarely apply ‘should’ to any scenario, particularly when talking about family building, routes to parenthood. So rather than should, this is more about can, or could – what could be done with leftover embryos, giving key options. 

Here are the four main pathways for leftover embryos:

1. Embryo donation to another couple

Donating embryos to individuals or couples struggling with infertility can offer the chance to bring hope to others. This is often referred to as embryo adoption, although legally it differs from traditional adoption.

Steps to consider:

• Discuss your wishes with your clinic. Many clinics partner with embryo donation programs and can guide you through the process.
• Understand the legal and emotional implications. In most cases, donated embryos are given anonymously, but some programs offer open donation options where contact may be possible. 

National guidance: 

In the US, the National Embryo Donation Center (NEDC) is a trusted resource for people considering this pathway.

2. Embryo donation to science 

Some people choose to donate their leftover embryos to scientific research. These embryos may contribute to advancements in reproductive medicine, genetic research, or stem cell studies.

What do scientists do with donated embryos?

Scientists use embryos for research into disease treatments, improved fertility techniques, and genetic health studies. This option allows your embryos to have a legacy of innovation and hope for future generations.

Steps to consider:

• Check whether your clinic collaborates with research institutions.
• Understand the ethical guidelines and ensure you’re comfortable with the intended use.

National guidance: 

Research embryo donation is regulated by strict ethical and legal frameworks in the US. The National Institutes of Health (NIH) is a key organization overseeing this research.

3. Thaw and discard 

For some, deciding to thaw and discard leftover embryos feels like the most practical option, particularly if the emotional or logistical aspects of the other choices aren’t ideal, or feel overwhelming.

How do you say goodbye to embryos?

This is a key and prevalent question within our corner of the fertility community. We’d very much recommend looking at options for expert counseling in this area too, alongside your plans to say goodbye to your embryos, in the right way for you. 

• Acknowledge the significance of the decision. Some people find comfort in holding a small ceremony or writing a letter as part of their goodbye process – perhaps finding a quiet spot that holds significance or a feeling of comfort and safety. 
• Work closely with your clinic to ensure the embryos are handled respectfully and in accordance with your wishes.

Whether you’re discarding or donating – finding a safe, peaceful way to say goodbye to your embryos can be a crucial aspect of processing your experience as you move forward. 

Steps to consider:

• Clarify your intentions with your clinic. Most clinics require written consent for this option.
• Seek emotional support if needed. Many infertility counselors specialize in helping individuals process these decisions.

4. Keep embryos frozen (cryopreservation) 

Continuing to store embryos is a valid option if you’re not yet ready to make a decision. However, this comes with financial and emotional considerations, as clinics typically charge annual storage fees.

What do clinics do with unused embryos?

Clinics store embryos under strict conditions to preserve their viability. If you choose to keep them frozen, ensure you stay informed about your clinic’s policies and timelines for decision-making.

Steps to consider:

• Review storage agreements with your clinic.
• Set a timeline for revisiting the decision in the future. 

National guidance

The American Society for Reproductive Medicine (ASRM) recommends re-evaluating your plans for frozen embryos every 1-2 years.

Questions to ask yourself (before making a decision)

Making a choice about leftover embryos is deeply personal. Here are some questions to guide your reflection – there will be many, many more depending on your situation:

• What is important to us, in this decision-making process? What are our priorities and motivations? 
• Are we certain our journey with these embryos is complete? And (depending on your situation) is our family complete? 
• Do we feel comfortable with another family raising a child biologically related to us?
• Do we want to contribute to scientific research and advancements?
• What financial and emotional factors are influencing our decision?

Having open, honest discussions with your partner (if applicable), as well as your healthcare team, can help clarify your preferences.

Emotional support and counseling

Deciding what to do with leftover embryos can stir up a range of emotions, from grief and guilt to relief and acceptance. You don’t have to navigate this alone.

Infertility counselors and therapists specializing in reproductive issues can offer a safe space to explore your feelings. They can also help you process the symbolic and emotional weight of your decision.

How to find support:

• Ask your clinic for counselor recommendations. We can’t recommend online support from Dr Marie Prince enough, in this area. 
• Look for professionals certified by the Mental Health Professional Group (MHPG) of ASRM.
• Join online support communities for individuals facing similar choices – make a start with The Ribbon Box on Insta – we see you! – and get to know what the best support looks like, for you. 

Putting your wishes into action

Once you’ve made your decision, here are a few practical steps to take:

1. Contact your clinic: Communicate your intentions clearly. Most clinics require written consent forms for any action taken with embryos, whether it’s donation, disposal, or continued storage.
2. Seek legal advice (if needed): For donation pathways, particularly to other couples or research, legal agreements may be required to outline consent and rights.
3. Document your wishes: Ensure you keep copies of any forms or agreements for your records. This is especially important for future reference if you’re keeping embryos in storage.
4. Take time for closure: Whatever path you choose, give yourself space to acknowledge the decision and process your emotions. This might involve talking with a counselor, holding a personal ritual, or simply taking time to reflect.
   

Final thoughts: Your choice, your path

The decision of what to do with leftover embryos is as unique as your fertility journey. Whether you choose to donate, discard, or preserve them, know that there is no “right” or “wrong” choice – only the one that aligns with your values, goals, and emotions.

By understanding your options, seeking guidance, and allowing yourself the grace to process, you can make a decision that feels right for you and your family.

We’re here to support, wherever you’re at in your journey. DM us with any questions, and any content or topics you’d like to see covered.