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Making a decision
If you have frozen embryos remaining, it is often a complex and emotional process to decide what to do with them.
Our counsellors are always available for support, and to discuss how you feel about the choices. You might want to know:
- what are our options?
- what should we do?
- how do we decide?
Counselling is always available to help you make the right decision for you.
It is normal to experience a wide range of emotions including grief, loss, confusion, indecision, anxiety or depression.
Some find the decision-making process too difficult and avoid it by ignoring the letters about embryo storage, or delaying the final decision. This is a very normal response to a difficult process.
Others find it a simple decision.
Deciding what is best can be challenging. You might need time, discussion and reflection. Support networks can be useful, including friends and family or more formal networks like IVF friends or a Monash IVF counsellor. There is no right or wrong way to feel. The decision needs to be right for you.
What are my choices?
Your choices are to:
- use your embryos yourself
- keep the embryos in storage
- donate the embryos for embryology training
- donate the embryos to research
- dispose of the embryos
- donate the embryos to another couple
- statutory disposal of the embryos.
Use your embryos yourself
Circumstances can be very different between individuals – some have children, some don’t.
If you have not had any children, deciding to stop treatment and not to use any more embryos can be a very difficult and final step to take.
If you do have children, you may want to discuss if you are sure you don’t want any more children. Things to consider if you’re thinking about having another baby:
- can I put myself though this again? (emotional issues)
- do we have enough room for another child? (practical issues)
- can we afford to have another child? (financial issues)
- am I too old to have another child? (physical issues).
It’s important to discuss any differences in opinion about the decision. For example, if one partner wants to have more children and the other partner does not, this can cause anxiety. It’s important for both partners to accept and fully consent to a decision, without pressure.
If you decide to use the embryos, it may stir up feelings about previous attempts at IVF: it can feel like you’re getting ‘back on the rollercoaster’.
Some couples decide to continue to use their frozen embryos because they don’t see the other options as suitable. If there is more than 1 embryo, they could use 1 and have another child, and there will still be embryos remaining to decide on.
Keep the embryos in storage
After 5 years in storage, (or at the end of an approved storage extension time), a decision must be made about the embryos.
To extend the storage time, you must make an application to Monash IVF. For an extension of over 10 years, you must apply to the Patient Review Panel (Victorian Government, Department of Health).
Donate the embryos for embryology training
Embryos donated to this program are carefully managed under National Health and Medical Research Council guidelines.
Embryos are used in the training program for Pre-Implantation Genetic Diagnosis (PGD). Training programs may involve:
- test development
- biopsy training
- quality control.
PGD is genetic analysis of the embryos and is important for couples carrying diseases such as Cystic Fibrosis, Huntington’s Disease and Muscular Dystrophy. PGD is a treatment option for women with a greater risk of genetic abnormality in their children, and for couples with repeated unsuccessful IVF cycles. The scientific procedures used in PGD are highly skilled and specialised. Donating embryos to this program helps advance the science of PGD.
Donate the embryos to research
Research (where embryos are thawed and destroyed during research) mostly involve live embryos and these research studies are rare. If you are interested in this option, you can enquire with the Monash IVF team.
Dispose of the embryos
Choosing disposal can be a very personal decision. Views vary depending on values and beliefs. Some people view the embryos as cells, whilst others may view them as the start to life.
It can also bring up thoughts about the connection between the embryo and any children you have. You may also wonder if this last embryo or embryos could have been ‘the one’ to work.
Statutory Disposal of embryos
At the end of any storage limit for embryos (or the end of any storage extensions), if an extension is not requested, we are obliged to dispose of the embryos within 3 months of the expiry date.
We contact patients with frozen embryos one year, 6 months and 2 months prior to the expiry date. Patients are sent information and forms about applying for an extension or other options. If no decision is made by the patients, the embryos are allocated to Statutory Disposal and disposed within 3 months. This means if patients don’t want to sign disposal forms or make the decision, they can ignore the letters knowing what the outcome will be. Many people prefer this, as it’s sometimes too hard a decision to make. We will not contact the patient again after the expiry date has passed.
Donating the embryos to another couple
Some couples can identify with people having problems getting pregnant and want to donate their embryos to help them. Some couples want others to benefit from the science that helped them, or want to give the embryos a chance at life and help someone else struggling with infertility.
Donating eggs, sperm or embryos is a wonderful gift, but it is not a decision to be taken lightly.
Embryo (and gamete) donation are being discussed more openly as ideas of the ‘normal’ nuclear family in Australia become more complex. Our world is made up of families with adopted and step children, donor conceived children, surrogates, female couples, male couples and single women.
If you are thinking about donating your embryos, it’s important you understand and accept a genetically-related child will be brought up in another family.
Things to think about:
- Would you ever stop thinking about them? Worrying about them?
- Would you want to stay in contact with the family if this was an option?
- Do you feel the embryos are yours, or are you comfortable giving them to someone else and losing control of them?
- Will other parents love the genetic siblings of your children as much as you love your own kids?
- Are the embryos going to a ‘good’ home? You may start to imagine the couple who may use your embryos.
Monash IVF tip: If you already have children, it’s crucial to think about if you would tell your children and how they might react. This is a big decision, especially as the donor conceived children may want to contact you in the future.
Donations are not anonymous
At age 18, children born from donor egg, sperm and embryos can access information about the donors. Children under 18 can have their parents apply on their behalf to access the information, but the donor must consent before the information is released.
It’s important to think about implications for you, your children and your family. How would your own parents feel about having a grandchild brought up in another family? Will you be willing to have a relationship with the child if they choose to contact you in the future? Some couples may welcome this contact. For others, it will be the main reason they decide not to donate.
The law about donor information
Under current law, information is kept about the donors, recipients and any child born as a result of a donor procedure. Each state has slightly different rules and regulations.
The relationship between donor and recipient
Donor conceived children often want to meet the donors a few times, and then have minimal contact. The main reason children contact their biological parents is to find a missing piece of the puzzle in their lives. Some want to satisfy curiosity about who they look like, know more about family medical histories, or know about possible siblings.
Other times a relationship develops. It is difficult to predict how you’d feel in this situation in 20 years – it’s important to discuss the scenarios and how it may affect your family.
How likely is it my embryo will result in a baby?
Not all embryos survive the thaw process before a frozen embryo transfer: 70% of embryos frozen on Day 3 and 90% of embryos frozen on Day 5 will survive.
Pregnancy rates in donor embryo recipients are lower than couples transferring their own frozen embryos.
Many donated embryos will never be a pregnancy or birth. No one should donate assuming it won’t result in a birth, or that it will.
Could my child meet up with a person conceived from my donated embryos and become romantically involved?
This is statistically unlikely, but still a major area of concern for many people. The issue of openness vs. secrecy is also very important, and would be a main point of focus in the counselling sessions. This is a good reason why donors should follow up on the outcomes of their donation so they know if this is a possibility.
Who are the recipients?
Most recipients are couples with a long history of unsuccessful IVF cycles: donor embryo treatment is their last chance. They could be in second marriages with children from previous marriages. They may have children but are unable to become pregnant again. They may be single women or same sex partners.
How long will the donation take?
Time between donation and transfer of embryos can be up to 1 year or longer – it could be 1 month or 5 years.
If we donated and a child was born, would they have any claim to our will or estate?
No. Donor conceived children have no legal rights or responsibilities to their donors, and donors have no rights or responsibilities to their donor conceived children.
Do we get to choose who our embryos go to?
You can do a known donation and find a recipient yourself.
If you choose an anonymous donation to Monash IVF, you can choose (within reason) who you want to donate to (for example to a couple or someone without children). If you place a lot of conditions on the donation, it will probably be impossible for Monash IVF to find a recipient. If there are a lot of conditions, we may suggest you consider not donating. Part of the donation process is ‘letting go’ of the embryos and any child that is born.
Can we access personal information about the recipients such as job and marital status?
If the donation is anonymous, we don’t usually release personal information on the recipients – unless they specifically request it to be released if the donation results in a birth. Donors can request their embryos are donated to someone of a specific marital status.
Can we find out if the embryo transfer was successful and resulted in a pregnancy?
Donors are legally entitled to know:
- if their donation has achieved a pregnancy
- if their donation has resulted in a live birth
- the gender of the child
- about any birth abnormalities.
If none of our donated embryos turn into births, is there counselling available?
Yes. There is always counselling available free of charge to anyone who is thinking of donating, has donated, or is a child of a donor procedure through Monash IVF.
Some people who donate embryos are upset if a pregnancy and birth doesn’t result, feeling they have ‘let the recipients down’. This is a common reaction, and the donors are welcome to counselling and support.
If you need more information about any of these options, if you have a question or just want to talk to someone, please contact the Counselling Department at your Monash IVF clinic.