These moms donated their leftover embryos. Here's what it's like.

Each year in the United States, fertility treatment centers perform hundreds of thousands of assisted reproductive cycles in which eggs or embryos are handled. In 2020, for example, there were 326,468 such procedures. And of those procedures, 75,023 births resulted, accounting for approximately 2% of the country's live births. Another 123,304 of those procedures involved the banking of eggs or embryos (a fertilized egg), meaning they were frozen for use at a later time.

A ruling by the Alabama Supreme Court in February has brought new scrutiny to what happens to these frozen embryos, which the court determined could be considered children under state law. As such, it would be illegal to destroy any leftover embryos. The ruling has raised concern about the future of IVF, and prompted some fertility clinics, including the University of Alabama at Birmingham, to pause IVF treatments rather than expose their patients and providers to legal risk.

While there is no hard data on the outcome of cryogenically preserved embryos in the U.S., some people in recent years have chosen to donate their unused embryos to others who may not be able to create their own. Instead of storing their embryos indefinitely or authorizing them to be destroyed, these donors — whether privately or through an agency — pay it forward to others going through the painful infertility journey that they themselves experienced.

“Before we started our fertility journey, I made it really clear to my wife that I was not going to be destroying any embryos,” says Estelle, a mother of three who asked to not use her last name. “I never cared about donating. It never bothered me. I had no hang-ups or moral compunction, no ‘this is my child’ feelings.”

When a good friend confided that she wanted to have children but that her own biological embryos were not succeeding, Estelle — thinking that she and her wife were finished having children after their first two — had no hesitation in offering her the remaining three embryos from her own experience using in vitro fertilization (IVF). Because this was a privately arranged donation, Estelle was able to designate her friend as recipient without any further testing or legal issues.

While the transfers were unsuccessful and her friend was unable to carry a pregnancy to term, Estelle always knew that had a child resulted, she would have been in that child’s life. “We planned to be open with the child,” she says. “Had the baby been born, we would have made a more regular effort so that the kid knew its genetic family.”

After Estelle donated her remaining embryos to her friend, she decided to have another child. This time, given her age and delays caused by COVID, she opted to use a donated embryo. “There were four or five in the donor bank and I was given a choice after reviewing the profiles of the parents. I paid a $1,000 administration fee to cover paperwork and testing,” Estelle says.

After implanting the donated embryo, Estelle went on to have a successful pregnancy and delivered a son. “He is 100% mine, no question,” she says of the boy, who is genetically different from her other children and a different race. “We didn’t know what he would look like before he was born. But there is nothing of him not mine,” she says.

While the donor process in this case was anonymous, Estelle has requested that her fertility doctor convey a message to the donor parents that their child is healthy and happy and loved. “We really want them to know,” she says. “And if they decided to meet him, we would say yes.”

But Estelle recognizes that just because the process was anonymous does not indicate indifference. “There’s a level of care required to donate embryos, because it’s not so easy. The embryo bank requires psychological counseling, FDA testing and a lot in order to donate which wouldn’t be necessary if you were to discard them,” she says.

Much like other paths to pregnancy, age is a contributing factor to the success of IVF in general as well as embryo donation. There are, however, no distinctions between regulations for donor embryos and traditional IVF. According to Dr. Beth McAvey, who is board-certified in reproductive endocrinology and infertility as well as obstetrics and gynecology, the American Society of Reproductive Medicine says that embryo transfer is not recommended past the age of 50, with some exceptions made for patients up to 55 with no medical comorbidities. “We will engage with a high-risk ob-gyn to obtain pre-conception advice in older recipient patients,” McAvey says. Individual clinics may also adhere to their own set restrictions for donors at the age of embryo creation, although there is no national standard or requirement and most clinics rely on embryo testing to determine whether or not the embryo is healthy.

When Christie and her husband tried to start their family, they were unable to conceive on their own. “We tried to have children like everybody else, but after a long time, we decided to get help with it,” says Christie, who also opted to not disclose her full name for privacy reasons. “We did IUI [intrauterine insemination] three times, and when that didn’t work, I gave up hope for a few years. But four years later, in 2017, our doctor said if we were willing to try IVF, now was the time.”

Due to genetic factors, Christie was unable to stay pregnant using her own genetic materials. After a miscarriage, she spent a year grieving the loss of her own fertility and the inability to have biological children. She and her husband switched physicians, and the fertility specialist offered them donor material — both sperm and egg — to create embryos. On their second try, they found compatible donors and were able to create 16 healthy embryos.

“My first pregnancy, the doctor transferred two embryos, and I was able to successfully deliver two babies,” Christie says. And on the second attempt at age 42, the doctor transferred two more embryos, though this time only one pregnancy resulted. “I would have liked to have four children, but three was the total number we have,” she says.

At this point Christie and her husband had 12 embryos left over, and they needed to decide how to proceed. They did not want to have more children, but Christie also didn’t want the embryos to be destroyed. “For me, I want them to be a person and be on this earth and live their life,” Christie says. “That’s my faith belief.”

While the embryos were not genetically related to Christie and her husband, they are biologically connected to their children, and so she had some requests when donating. “We wanted the children to grow up with a faith tradition like their siblings,” she says. Christie and her husband know the realities of modern-day DNA-matching websites, and they have always been transparent with their own children about their origins, so they plan on also sharing the news that other siblings may exist.

Through her doctor, Christie learned of Embryo Connections, a concierge embryo donation program that connects donors with intended parents. They facilitated the donation of Christie’s embryos. At present, her remaining four embryos are being placed with a receiving family.

Embryo Connections was started by Deb Roberts who started her own family using donor embryos. For donors, Roberts says that the matching process is completely cost-free, while those receiving donor embryos pay between $9,000 to $11,000 to cover legal, medical, shipping and counseling fees. Embryo connections has specific parameters for donated embryos that differ from other services. “We go up to age 42 for egg contributor and 62 for the sperm contributor,” she says, “But all the embryos are tested.” Additionally, because Embryo Connections requires the embryos to be ‘full blast and vitrified,’ meaning at least four days old, most of the embryos they receive were created after 2010, when freezing technology made this possible. This age increases the chance of a successful implantation and pregnancy for intended parents.

Roberts sees her service as a life-affirming one that provides intended parents with the chance to have children. “The fertility industry has a big gap because they don’t want to consider anything other than moving human tissue where it needs to go,” she says. “It’s extremely clinical.” But Roberts created her agency with the wishes of donor-conceived persons in mind, and to fill a gap for those who don’t fit into the parameters of other donor agencies. “Faith-based organizations have restrictions on marital status, sexual orientation and age,” she says. “We just want to give people the opportunity to parent without these restrictions.”

This article was originally published on July 19, 2023 and has been updated.