When you first begin the preimplantation genetic testing (PGT) process, you may not think about what happens after embryo transfer or the possibility of having extra embryos for a future frozen embryo transfer. However, if you do have embryos that weren’t used in an IVF cycle, what are your options?
With PGT, some of these embryos may be affected by the genetic disorder you’re testing for, and some may be unaffected. Deciding what to do with remaining embryos is an important conversation to have with your physician and/or genetic counselor, and it’s something you’ll want to start thinking about early on in the PGT process.
It’s also important to remember that your options may vary depending upon what your clinic offers, so make sure to ask as many questions as possible at the outset.
Understanding your options and learning more about what happens after embryo transfer can help you make the best choice for your family.
Future Cycles for Embryos
If you finish your IVF and PGT cycle but have embryos left over from the process, they can be stored by the fertility clinic for future use. Before you begin IVF, you may want to ask your clinic about their policies both for storage of unused embryos, and for transfer of embryos with different types of genetic test results. Make sure you ask how long your clinic can store the embryos for you, as some may have a time limit, according to the infertility association Resolve.
If you’re not sure you’re done building your family, you may want to hold on to your extra embryos for a future cycle. The laboratory where you did your IVF can store them for you — safely frozen and in liquid nitrogen — for an annual fee. The fertility clinic keeps each embryo labeled so that they can look up the genetic testing results prior to a frozen embryo transfer.
Embryo Disposition
If you know you won’t be using your remaining embryos and don’t wish to store them, some couples choose to thaw and dispose of the unused embryos, says Alison Coates, PhD, Embryology Laboratory Director at Oregon Reproductive Medicine. This requires a notarized consent form from both intended parents. The embryos are thawed to room temperature, at which point they stop growing.
You may want to ask your clinic what their policy is regarding embryo disposition, so you know exactly how it will be handled if you choose this option.
Donating Your Embryos
Scientific Research
Even if you know you won’t use your embryos, you may be able to donate your embryos to scientific research, where they can help scientists discover the underlying mechanisms of diseases.
For example, Oregon Reproductive Medicine has a collaboration with a research laboratory in Colorado, says Coates. “They use the embryos in metabolic studies and to understand more about various genetic diseases,” she explains. “They have different projects so the specifics are changing all the time.” This may be an attractive option for couples who have unused embryos from PGT that are affected with a genetic disorder. Many fertility clinics have collaborations with research laboratories similar to this.
Open and Anonymous Donation
Another option that some couples choose is to donate their remaining embryos to individuals or couples who, for personal or medical reasons, are looking to receive donated embryos to create their family. Embryo donation allows for recipient mothers to experience pregnancy and control the pregnancy environment. Donating embryos to an infertile couple is an increasingly popular option, which benefits both the donor family and the recipient family. “Some people really love to do this,” says Coates. “The people who choose this option are generally very satisfied with this outcome and feel like they’re doing something really good for someone else.”
There are two types of embryo donations, according to Resolve: known (open) and anonymous. In a known donation, you help select the person or people who will receive the embryos. Some people choose to have ongoing contact with the recipients of their donated embryos, including contact with the resulting baby.
Anonymous donation is just that: your IVF clinic (usually) will select the recipients, and the donor couple may not know if a pregnancy or birth resulted. Besides embryo donation programs within your own clinic, there are outside agencies that run donation programs with various criteria and guiding principles.
If you wish to donate your remaining embryos to another couple or individual, there are a few extra steps that you’ll have to take, including a psychological evaluation, some medical testing to ensure that no infectious diseases are transferred, and, of course, a legal agreement that must be signed by all parties.
Other Considerations
It’s also important to think through the psychological impact of your decision — remember that this is an intensely personal decision and can be a sensitive and difficult topic for many couples and individuals. Regardless of what you choose, knowing what you plan to do with extra embryos and understanding your range of options can offer peace of mind on your PGT journey.
Lauren Arcuri is a freelance writer in northern Vermont. She writes about science, health, and medicine, including genomics, neuroscience, and rare diseases. She has written for Pacific Standard, Proto, Genome, Yoga Journal, and many other publications.