What Do I Do With My Leftover Embryos?

In a tank across town, suspended in liquid nitrogen at -320°F, float my leftover embryos, whose future is unknown to me. From this batch, I have two children, and my husband and I feel confident our family is complete, yet the storage fee is due soon, and I just might pay it.

When couples begin fertility treatments, they sign consent forms about various endings: what happens to the embryos should the couple divorce, for example? And, improbably in that hopeful and desperate moment, what if you are left with more than you can use? The options are generally to store them, donate them to another patient, dispose of them, or donate them to science.  [time-brightcove not-tgx=”true”]

To have more than you need is lucky, especially after the heartache and slog of fertility treatments. We have so many embryos—I’m talking in the dozens—because I had what the doctor called “an exuberant response” to the medication I took to stimulate egg production. In fact, I had to adjust medications twice to prevent something called ovarian hyperstimulation syndrome. This all sounds like I’m bragging, and I rarely tell people the exact number of eggs the doctor retrieved from me or the number of embryos we still have in storage because it’s a tender subject for people who don’t have enough. But like all IVF complications, it was intensely painful, and for a few days, a little scary. 

Reports for the number of embryos frozen in the United States vary significantly, but the National Embryo Donation Center puts the number at close to 1 million. And a 2010 study suggested that most people who have embryos stored, about 63%, feel as inert as I do about the next steps, delaying any decision by about five years, instead opting to pay the storage fees (usually a flat fee of $500 to $700 per year) as we feel out which choice feels right, or maybe just the least wrong.

According to a study published in the American Society for Reproductive Medicine’s journal Fertility and Sterility, factors like patients’ personal beliefs and values, individual life circumstances, embryo quality and quantity, and clinic support influence how people make this choice. Those certainly have shaped the conversations my husband and I have had since our second child was born a few years ago, bouncing between priorities and beliefs, forged in the intensity of all I, we both, went through to bring our children into the world.

At one time, before I had kids and it was all an abstraction, the choice seemed clear: I knew I wanted to donate the embryos so that another person or couple could have a family. My general philosophy is if one person has too much of something, it is ethically correct to share it with someone else who doesn’t have enough. But now, the more I think about the children I didn’t have, the more I wonder how their potential lives away from us might impact me, my husband, and the children I do have.

My friend Krys considered donating his and his partner’s embryos once their family was complete. Krys is trans and said he thought about the amount of money and pain it might save another queer family, but as a parent of sperm-donor-conceived children, he was also concerned that a kid being raised without one or more of their biological parents might, at times, feel a sense of loss. “I didn’t feel it was fair to anyone in this intentional family to add more levels of disconnection, to separate my kids from siblings or their siblings from us and from their biological father,” he says. So Krys and his partner offered the surplus embryos to their sperm donor, since he was the only person they thought could ethically welcome their kids’ siblings into the world. Their sperm donor and his partner thought about it, but ultimately passed. 

Another friend, Jo, is holding on to her four surplus embryos because of a possibility she isn’t ready to let go of yet. “There is a part of me that really wants to have a third kid,” she said, but “we can’t be the parents we want to be unless we had more money and I didn’t have to work as much.” Jo and her partner feel disappointment and sadness around the idea of destroying their remaining embryos, which would essentially end their fantasy of having a third child. 

Like everything around parenting, from sleep training to breastfeeding, having children has made me much less judgmental of other people’s decisions. I know how difficult it all is, and believe we are all doing the best we can in the circumstances in which we exist. This choice, like so many, is a deeply personal one playing out on a political stage, since embryos represent a category between what counts as life and what doesn’t. Those of us with frozen embryos currently have the opportunity to decide what to do with them, even if the choice doesn’t feel particularly clear-cut, but at a time when women’s agency and autonomy is being restricted, we know that may not always be the case. 

The new Trump Administration, which has gestured at fetal personhood, gives Jo more of a sense of urgency. “I think the thing that has pushed me toward at least landing somewhere with a decision is just how unpredictable—but also predictable—the current Administration is. I feel very uncomfortable about a decision being made around my embryos that isn’t left up to me.” Jo turns 40 next year, and she is betting her rights to her embryos won’t change before then, but then if she’s positive she isn’t going to have that third child, she will likely dispose of them. “I just don’t want them in the government’s control,” she says.

Research has shown that many couples do not anticipate or appreciate the consequences of having remaining embryos before starting IVF. According to one study interviewing such couples published in Fertility and Sterility, the significance they attributed to their embryos also had a lot to do with their experience doing IVF. “Parents variously conceptualized frozen embryos as biologic tissue, living entities, ‘virtual’ children having interests that must be considered and protected, siblings of their living children, genetic or psychological ‘insurance policies,’ and symbolic reminders of their past infertility,” according to the researchers. 

When I think of my own embryos, I think a lot about how hard it was to end up in this position—the invasive tests on my body, the pain of that egg retrieval, which, because my ovaries hyperstimulated, resulted in internal bleeding and severe pain, and the failed transfers before both successful pregnancies. I also remember both times I took a home pregnancy test and saw that faint second line, how an entirely new world opened up inside me. I think about the blood I saw both times when I had a subchorionic hematoma in my first trimester, and how my body felt when I believed I was losing the pregnancy, and then the miracle of hearing the heartbeat of my daughters at my next appointment. These experiences make me place significance on all the embryos we have left. I want to honor the embryos that could have been my children, but will never be. I want to honor the two children I do have. And I want to honor myself and all I went through to have the choice in front of me. But sometimes it’s unclear what that looks like.

At first, during my more superstitious moments, the idea of having extras felt like an insurance policy. Should the unimaginable happen, and we were plunged into grief and despair, not having those embryos–and at least the chance to provide my living child with a sibling–because of a choice I made would only deepen an already unbearable tragedy. But I also knew that I was spinning out hypothetical situations, trying to tease out every possible scenario, even the most excruciating, before making an irreversible decision, and that having a stockpile of frozen embryos would hardly bring me solace in this one. Plus, I was aware of the reality that, eventually, we will be too old to have another baby anyway. 

My husband and I had just about settled on donating our embryos so another family could use them when a friend punctured my carefully thought-out plans by asking, simply, what if they all find you on a genetic-testing website? What if they find your kids? It was a specter that disturbed me, and I feared what they would say to me about the choice I had made, whether these grown-up children I hadn’t raised would feel abandoned. Up until then, I had been thinking of other couples who needed embryos, but hadn’t thought as much about the embryos themselves, and their own futures, should we take that route. The possibility is a lot to bear. 

We are now also considering medical donation, a path that still makes me feel uneasy, because I wonder what research will be conducted on them, and what will be discovered as a result. And yet there is a real cost, both financial and emotional, to our hesitancy to pick a path and move forward. I think about how procrastinating their decision has so far cost my friend Laura and her husband $2,100, but also how it will feel like closure of a difficult chapter of our lives to let our embryos go, one way or another.

Laura and her husband thought about letting someone else adopt their three surplus embryos, since she knows someone who has been able to have a family through embryo adoption. But ultimately, she says, “it felt too distressing to me to know that there might be our child out there without knowing us.” Where they’ve landed has everything to do with where they started, namely the UCSF Center for Reproductive Health, which Laura says “did us so much good by helping us along the way in terms of both when I got pregnant the first time and then helping us through the surrogacy process.” Laura feels ready to donate her embryos to the place that made her family possible.

“I hope that they can use the embryos for research and learn something that really helps make a difference in care or pregnancy,” she says. “But in reality, these are a bunch of cells that could have been our kids, and at the same time very much are not our kids, so there’s a really surreal quality wondering what could have been, while there’s also sort of the practical need to pay attention to our two kids now who need to be taken to school and baseball practice and have diapers changed.”

Krys believes that a large part of “queer family-building ends up being about making choices that never feel 100% right. The decision to donate the embryos to science and to permanently close off our fertility was another one of those imperfect but correct choices that allowed us to have the life we have,” he told me. 

Maybe that’s the best I can hope for when faced with this bizarre abundance, to realize no choice may ever feel 100% right, but as with sleep training and breastfeeding, all we can do is consider the information before us and do our best in that moment. What has taught me the most about how to stop dwelling on all the possible outcomes for my unused embryos is parenting my two children. My daughters have an almost miraculous ability to keep me in the present—they need a snack, a lullaby, a book, their nose wiped. I see my children as they are, but I see their potential as well, the people they could be, the lives they could lead. I can’t help thinking ahead to how their futures may play out. Still, my kids are showing me every day that the only thing I know for sure is what’s right in front of me. It’s easy to get caught up in what if, but I need to focus on what is.