Leftover Embryos After IVF: A Family Member’s Concern

A reader writes: “I am the (conservative Christian) mother of a (not-as-conservative Christian) couple just beginning their IVF journey. I am concerned that they have not fully considered the subject of leftover embryos and how many to harvest/fertilize/freeze. What advice do you have for the ‘grandparents’ and extended family members? Is there ever a time when we should/could give loving advice? I want to be able to understand what they are going through: the procedures, the emotions, etc….They seem to only want to get their info from their doctor right now. “

When I read this question, I knew that I needed to ask my friend, Katie, for her thoughts on how to respond. Katie has created an amazing website, Beautiful Pieces Of Us, with the specific purpose of encouraging and supporting people who are struggling to make decisions regarding their “leftover” embryos. Katie’s very wise response is below.

The topic of leftover embryos is definitely one of the things that should be discussed in length with a couple’s reproductive endocrinologist before embarking on the journey of IVF. If you’re a family member of someone about to begin IVF, and you have concerns about the subject of leftover embryos, let me say, you’re right on target. Your concern is legitimate and obviously born out of love.

However, as you may already know, when a couple enters the doctor’s office to pursue their dreams of having a family, the reality is leftover embryos are usually nowhere on their radar. Most parents-to-be who get to the point of needing reproductive assistance are typically at the point of desperation and fail to truly consider the possibilities and weigh the consequences of “life after IVF”. It’s nearly impossible to grasp the concept of “too many” when they’re simply hoping and praying for just one.

I have to say I understand. This was us 10 years ago. There’s a lot to consider here.

So let’s talk about it.

First, in terms of success rates, it’s difficult to know where a couple will fall on the spectrum before IVF begins. There are so many variables that impact the outcome, many of which are completely outside anyone’s control, save God.

Couples, and even physicians to some degree, are left to wonder – will it take two, three, four, or five rounds or more just to produce one good quality embryo for transfer? Will they harvest dozens of eggs only to have just a few fertilize? Or will they respond favorably during the first fresh cycle, produce an abundance of embryos, and get pregnant fairly easily?

Truly, the only guarantee going into IVF is everyone is different and no two courses of treatment, or their associated outcomes, are exactly alike.

So, it’s really hard to know what will happen.

Second, there are some things you should know about why this is such a difficult area to broach prior to the start of IVF, before we talk about how to address your (very legitimate!) concerns. Unfortunately, four sobering truths are a huge reason why the topic of leftover embryos tends to fall by the wayside when a couple is at the very beginning of their IVF journey:

IVF is a game of numbers.

The first truth is that IVF is a game of numbers. The initial goal, through the use of gonadotropins and other reproductive medications, is to develop and retrieve as many mature eggs as possible without significantly overstimulating the patient. You don’t necessarily want 60 eggs, but you don’t want 5 either.

But after retrieval, the numbers go down from there. Not all will fertilize. Not all will grow properly. Not all will be normal. In fact, some couples even end up with zero by the time transfer day arrives. Leftover embryos are a very real possibility, but so is having little to no embryos. Most couples don’t think they’ll have too many – they worry more about having too few.

Based on a large number of factors, physicians aim to give patients the highest chance of pregnancy by having enough good-quality embryos to use in a fresh cycle and/or freeze for later use should the fresh cycle fail.

But even the physicians can’t predict everything, although they certainly try. They never know exactly how each individual patient will respond to treatment. Sometimes it’s a massive fail and sometimes it’s wildly successful. Sometimes there’s just no rhyme or reason. But, one thing is for certain, it’s almost always a surprise, especially to the patient, for better or worse.

IVF is a considerable financial risk for patients.

The second truth is that IVF is a considerable financial risk for patients. With the incredibly high price tag, most parents want to make sure they have every opportunity for success, even if that means they produce a few more embryos than they really need.

For many, they can only afford to do this once and there are no guarantees it will work. When couples weigh the financial risk, they want to do whatever gives them the best shot at becoming parents with the smallest impact to their bottom line. After all, getting pregnant is just the beginning. Actually raising a child takes an even greater financial investment.

Additionally, if a couple wants more than one child, having a few leftover embryos may actually be wanted so they don’t have to pay for another fresh IVF cycle in the future, which can cost three times as much as a FET (frozen embryo transfer). Not to mention, if another fresh cycle is needed, couples would have to go through all the hormones, shots, appointments, and physical discomfort all over again. Going through FET is considerably easier in all respects and much less expensive.

(Most) IVF couples are conditioned to expect failure.

The third and hardest truth is that most IVF couples are already conditioned to expect failure – and rightfully so. In general, repeated failures are what bring a couple to IVF in the first place. Having leftover embryos may be viewed as an improbable scenario. Therefore, it may not be talked about as in depth as it should be.

Of course, there are many couples who must jump to IVF immediately when family planning begins due to other medical conditions. But, speaking in general terms, most couples have been through months or years of heartbreak before arriving at this point. Most of us don’t go into IVF expecting it to work. We go into IVF knowing it may NEVER work.

Why?

Because even though it’s been successful for so many, it hasn’t been successful for SO many others. Plus, by the time we reach IVF, we’ve had negative after negative after negative. We try not to lose hope, so we keep plunging forward – but it truly feels unbelievable and surreal when you finally get that BFP (big fat positive). Most of us never really think it will happen because we’ve been let down over and over again. IVF is the end of the road when it comes to having biological children, so it feels a lot like throwing spaghetti against the wall and hoping something sticks.

IVF Couples believe their feelings won’t change and/or they can tackle the problem later (if they even have leftover embryos at all).

The fourth and final truth is that most IVF couples have blinders on. They can only see what’s right in front of them – having a baby that they’ve desperately wanted for years.

Although the topic of leftover frozen embryos is brought up in pre-IVF counseling, and although couples must sign initial paperwork indicating their wishes for disposition of leftover embryos, the truth is they can’t even begin to truly process that information, simply because they aren’t living it yet. Once they’re living it, it’s at that point that it becomes a reality and everything changes.

Not beforehand.

But in the beginning, IVF couples believe 1) their feelings won’t change and/or 2) they can tackle the problem later, IF they even have leftover frozen embryos in the first place. And for some, their feelings don’t change. For example, some couples know they want to donate their embryos to another couple if they have too many, and that’s exactly what they do.

But more often than not, a couple who ends up on the other side of infertility with leftover embryos to spare begins to question their initial choice all over again and deciding what to do becomes a deep and sobering struggle.

The problem with all of these truths is they cloud the picture for couples at the beginning of the IVF journey. They truly can’t see or understand what might be in their not-so-distant future.

Now, with all this being said, I’m not implying whatsoever that couples shouldn’t consider the consequences of IVF and the implications of leftover embryos before they start the process. They absolutely should. This is an extremely important consideration for all IVF candidates. When deciding to use IVF to build a family, it’s important to think long-term, far beyond the first cycle and the next few years. Rather, due to the risk of leftover embryos, it’s wise to think in terms of many years or decades.

We highly recommend couples new to the IVF journey speak to their physicians and other parents who have gone before them so they can truly understand the possibilities before they start their IVF cycles. It may have an effect on their position. Or it may not.

But, as you can see, either way, it’s really complicated.

What to Expect with Leftover Embryos

So, let’s get personal and real.

Every parent should prepare themselves for a rollercoaster ride when they embark on IVF, no matter how their course of treatment goes. However, being part of the latter group of patients who had a wildly successful outcome, my husband and I wish we would have been more informed about just how incredibly difficult it would be to make a decision about our leftover embryos.

We thought IVF would be the answer to our prayers and would finally bring our journey of family-building to a close.

Please don’t get me wrong – it was an answer to our prayers. We love our children fiercely – but instead of our journey coming to a close, it’s turned into an entirely new, even more difficult journey, full of heartache and sacrifice (read our story here).

We currently have 4 children, 5 embryos, and are preparing for FET again this fall. We originally only wanted 2 or 3 children, but now we’re taking it all the way, following the leading of the Lord and laying it all at the foot of the cross. But it took us years to reach this decision and come to a place of peace. Although we’re surrendered to God and we’ve accepted His plan for us, it sure doesn’t look anything like what we imagined 10 years ago when we started IVF.

In our opinion, it’s been 1000x times harder than facing infertility in the first place.

And we’re not the only ones who feel this way. In fact, I would venture to say this is a common sentiment among many, many parents with leftover embryos.

So, you may be wondering – would we do it differently, knowing what we know now?

Ah, that’s a loaded question with a complicated answer. And the response will be different depending on who you ask.

But, from our perspective, here’s the short of it.

We would probably do some things differently, but that still doesn’t mean we would have dismissed IVF altogether. Most of all, we wish we would have sought guidance from the Lord and taken the time to really think things through. However, over the years, we’ve come to understand that our journey and our lives are actually a reflection of God’s plan all along. At the time of our decision to pursue IVF, He knew we were young in faith, He knew we would continue, He knew the outcome before any of it came to pass, and He had a plan for all of it. He saw us then and He sees us now.

Today, we’re exactly where He intends for us to be, heartache, sacrifice, and all. He’s used our circumstances to lead us into spiritual maturity and draw us deeper into relationship with Him. Every child that has graced our family has enriched and blessed our lives exponentially. And here we are ministering to others about a subject that is rarely talked about but desperately needs attention. It’s all come to pass entirely because of God and our decision to pursue IVF. He has chosen us for this calling, both with our children and with our testimony.

But, even knowing all this, it still doesn’t make our position with our embryos any easier to swallow – this is by far one of the most difficult and overwhelming decisions we’ve ever had to face and one of the hardest things we’ve ever done. However, that being said, the answer is NO, I can’t say we would do it all that differently – we’re being used by God just as He intended – but I sure do wish we’d been more prepared for what was coming.

So, this is the honest truth that you must come to terms with no matter your belief system or worldview – having leftover embryos puts you squarely face to face with life, death, faith, and your own limitations as a human. Once it becomes a reality, there’s no avoiding it and there’s no way to make it go away – it’s there with you every day until you finally come to a resolution that brings you peace. For some, deciding what to do with leftover embryos can take decades to resolve. And even when it’s all over, the experience will live in your hearts and minds forever.

So what should you do?

If you’re the family members of a couple going through IVF, how do you lovingly and politely bring this to their attention?

First, you must realize this is an extremely sensitive topic for parents struggling with infertility. They have blinders on. They only want a baby and a family. They’re so used to seeing “Not Pregnant” on their pregnancy tests that they think IVF won’t work. They can’t grasp the concept that they will ever be fortunate enough to hold their own son or daughter. This was certainly true for my husband and me. We were defensive before anyone could even get a word out of their mouths.

But looking back, I wish someone had watched out for us and had the conversation with us, even if it was hard to hear. Yes, we had IVF counseling and this was definitely one of the topics we had to discuss in length. However, we still had no concept of what it would actually look like in everyday life, even AFTER discussing it in counseling and together on our own.

So, putting myself back in my own shoes before we started IVF, this is how I would recommend approaching a couple struggling with infertility who is about to start IVF – gently point them back to their doctor (who they trust) armed with some simple questions to ask. Nothing more, nothing less. Let the physician do the heavy talking to get their thoughts spinning.

(What questions should you ask your physician? There are many. For your convenience, we’ve put them all together into one file that you can download so you can take them to your next appointment.)

If you’re having trouble with the download form above, you can just click here.

The physician is the one who has the expertise and knowledge when it comes to diagnosis, the IVF plan, and expected response to treatment.

The physician is the one who sees the fallout after the IVF cycle is said and done.

The physician is the one who sees couples every day in their office, crying and grieving over what to do.

The physician and the practice are the ones who generate the bills for embryo storage.

They will be able to tell potential parents what to expect and what they may one day have to face better than anyone else at this point. And, if you find an opening in your conversations, gently point them to blogs like this to get informed about the possibilities and hear from other parents in this situation.

After that, you have to let go and let God.

Being too forceful or overbearing will only make your loved ones pull away.

Remember, unfortunately, these couples have blinders on, no matter what you say. It’s definitely very important to be as informed as possible. However, for most couples just starting their IVF journey, it’s simply very difficult to grasp the potential reality of leftover embryos.

If their hearts are set on IVF, you have to let it be. For some people, depending on their diagnosis, it really is the only way they can become pregnant. And the desire to be a mother or father of your own biological children is so intensely strong that many won’t consider adoption or other routes of family building until they’ve tried this one first.

But, no matter what happens, whether you’re the family or the patient, be prepared to get before God over and over during this process. If leftover embryos become a reality for your loved ones, please understand they had no way of knowing this was going to happen. It could’ve just as easily gone the other way. Even if you know all the answers to the questions provided in our list, there’s still a huge margin of uncertainty. You won’t know exactly what will happen until you get there. Lay it at His feet and accept His will. It’s totally out of your control…but it’s ALL under His control.

And finally, thank you for caring about your loved ones so much that you’re willing to step out in faith and come alongside them on the journey. Your love and support mean the world to us as we travel a road filled with deep sorrows and amazing joys.

Praying wisdom, discernment, and peace over your hearts for the conversations to come.

Katie ~ Author/Owner @ Beautiful Pieces of Us – Support for Parents with Leftover Frozen Embryos

Want to learn more? Visit our website at https://beautifulpiecesofus.com. After familiarizing yourself with the site, a few great articles to begin with are Leftover Frozen Embryos: 7 Truths on the Other Side of Infertility, Leftover Frozen Embryos – Always on My Mind, 9 Reasons Why You Should Talk About Your Embryos with Your Spouse, and 10 Reasons Why You Need Community When You Have Leftover Frozen Embryos.

Many thanks to Katie for sharing her thoughts and wisdom on this sensitive topic. Don’t forget to download our free PDF, Questions to Ask Your RE Before IVF.

Also, I realize that many of you are still hoping and praying for even just ONE good embryo. You, of course, are always on our hearts and are not forgotten.

Moral and Ethical Issues of IVF: An Interview With Matthew Arbo

Christian and IVF: Can I Honor God and Still Do IVF?