Many patients of assisted reproductive treatments will find themselves in the following situation: The dream to have a baby has come true and finally you can embrace the most beloved baby in the world. But there are still some frozen blastocysts stored at the clinic and you don’t know what to do with them. Most of the patients prefer to keep the embryos at the clinic because they still wish to have children in the future and because they are not prepared to let go of them.
What is the reason behind for these superfluos embryos?
A woman’s egg quality depends especially on her age. While doing the IVF ICSI treatment, the goal of the ovarian stimulation is to stimulate the ovaries to maximize the number of follicles that grow in that cycle. If the woman is still young, it’s very probable to retrieve a high number of good quality eggs. Two factors indicate if the fertilization of the egg will be successful: The quality of the egg and the quality of the sperm.
If the quality of the female and male gametes is high, it’s more probable that many eggs will be fertilized and many embryos will make it to the blastocyst stage – the 5th day of embryo developement.
The same is also true in egg donation treatments because the eggs of young and healthy donors are typically of very high quality. It’s important to understand that in both treatments, those done with the patient‘s own eggs and those performed using donor eggs, it is impossible to know the exact number of eggs that will fertilize or how many of the embryos will make it to the blastocyst stage. That’s the reason why doctors always recommend to fertilize all eggs. Patients who don’t want to create more embryos than the desired number to be transferred, for religious or ethical reasons, have the option to limit the number of eggs that are fertilized. In this case, the patient should be aware of the possibility that either no embryo or just a very few embryos arrive at blastocyst stage. It should be noted that the freezing of the embryos that are not transferred is not optional, but required by law.
What kind of options do I have for my frozen embryos?
Having frozen embryos after a treatment is actually a positive thing. If you later decide to have another baby, or in case the process does not work out as expected, a further treatment with frozen embryos is much easier and cheaper than a treatment in which embryos must first be created. But what options do you have if you don‘t want to have any more children, and you still have some cryopreserved embryos?
What are the options for my frozen embryos?
To answer this question, it’s necesarry to look at what the Spanish law states. According to Law 14/2006 („Ley 14/2006 de reproducción asistida“) there are the two options for patients who wish to stop storing their embryos: there is the option of donation, or the option of ceasing to store these embryos without any further use.
Regarding the donation of frozen embryos, there are two possibilities: donating them to science or donating them to other couples. Donating to science is somewhat problematic because, although this option does exist in Spain, it is not allowed to experiment on embryos and, generally speaking, the use of these embryos for scientific purposes is very limited. It is very likely that the embryos, even if they have been donated for scientific purposes, will have to be kept for years at the clinic, while the patients incurr on these storage costs until they are used.
Donating for reproductive purposes is another option. This option gives patients whose gamete quality is not good enough to produce their own embryos (and who sometimes do not have the financial means to undergo a fresh cycle with donated gametes), a chance to get pregnant. The treatment with donated embryos is called embryo donation or embryo adoption. If the embryos that are donated were created during an IVF treatment, it required that at the time of the freezing, the woman was not older than 35 years of age and the man was not over than 50.
If the embryos were created using donor eggs or donor sperm, it’s the age of the donor that counts. The rule is the following: if gametes other than –those of the donor are used as part of the fertilisation (using the couple’s gametes), further evaluation is necessary to be able to donate the embryos. The third option is ceasing to store the embryos. It is important to note that the embryos cannot be destroyed at the patient‘s request. The reason for this is that the law considers that an embryo is life and its destruction is subject to strict legal requirements. In order to stop the storage of embryos, two doctors have to certify that, for health reasons, the patient cannot carry out any other pregnancy. The age of the woman is not a determining factor in this case, because there must be a medical reason explaining the impossibility of further embryo transfers.
Up to what age can I transfer embryos?
Despite the widespread, but erroneous opinion, in Spain there is no legally determined age limit for using assisted reproduction techniques. Nevertheless, most fertility clinics have set an age limit is 50 years of age.
[M1]Third? Not second?