During the course of in vitro fertilization (IVF) treatment, most couples produce more embryos than they can use. This gives them the best chance that one or more embryos will survive to become children. Many unused embryos are frozen, a process called cryopreservation. [1-4]
At some point, couples must decide what to do with these embryos frozen in time. [1-4] In some cases, if sperm comes from an anonymous donor, a woman may be making these decisions alone, but for the purpose of this discussion I will use the term “couples.”
In the United States alone, there are over 600,000 embryos suspended in cryopreservation.  For some couples who have the family size they want, the decision to allow their embryos to thaw and be discarded is not difficult. For others, the decision can be agonizingly difficult. This is especially true for couples who believe that life starts at conception. 
The decision on the fate of frozen embryos does not need to be made right away. An embryo can be frozen for many years and still have the potential to grow into a child, but cryopreservation is expensive. It can cost $600 per year to keep one embryo frozen. [1,3]
Rather than facing a tough choice. Many couples pay the price of cryopreservation and delay the decision. They often delay the decision indefinitely and just keep paying year after year. Eventually, some couples just stop paying, like abandoning an old self-storage unit. There are better options. [3,4]
The Fate of Frozen Embryos
For couples who dread the thought of letting the IVF clinic dispose of their embryos, compassionate transfer may be an option. These couples may choose to have their frozen embryos implanted in a way or at a time that will not result in pregnancy. This option offers a way to let the embryos have a more natural end. There are three other options couples could consider: [1,3,4]
- They can use the embryos to have more children. For couples who are able to have more children, implanting remaining embryos may be an option. This is called a frozen embryo transfer and it can be about $10,000 less expensive than a complete IVF cycle that starts without a viable embryo.
- They can donate their embryos to a couple who want children but are unable to create their own embryos for IVF. This is called embryo adoption. Like child adoption, the adoption can be open or closed. Couples who want to maintain some contact with any children that result from the donation can opt for an open donation. Embryo adoption, like child adoption, can be complicated. There are embryo adoption agencies couples can work with to ease the process.
- They can donate embryos to research. This is a compromise option that some couples feel comfortable with. It does not result in life for an embryo, but it may help bring life to people with diseases cured through stem cell research. The Obama administration opened this option to more couples by lifting a ban that limited stem cell research to embryos created before 2001.
A study published in the journal Fertility and Sterility shows how difficult the decision on frozen embryos can be. The researchers found that 70 percent of people with cryopreserved embryos delayed a decision for five or more years. Of the people they surveyed who said they would not be using their embryos to have more children, 43 percent said they were very unlikely to let their embryos be thawed and discarded. 
The problem with postponing a decision, is that people may lose the ability to make the decision. They may lose the ability to pay for cryopreservation, get divorced, or pass away. The decision may be left to lawyers, family members, or the IVF clinic. [1,3]
The best time to think about the fate of frozen embryos is before starting IVF treatment. Many IVF clinics have counselors that can help people think through their options. It is also good to know what the clinics policies are on cryopreservation. [1,3] A good resource for people struggling with this decision is the National Fertility Association. They have a website on embryo donor options at: resolve.org/what-are-my-options/donor-options/donor-embryo.
- Verywellfamily, When You Have Extra Embryos After IVF.
- gov, Embryo Adoption.
- Parenting, The Fate of Frozen Embryos.
- Fertility and Sterility, Fertility patient’s views about frozen embryo disposition: results of a multi-institutional U.S. survey.