Parents’ conceptualization of their frozen embryos complicates the disposition decision

Abstract

Objective-To ascertain what couples think about their embryos and how they approach making a decision about disposition in light of the fact that the disposition of unused frozen embryos has significant implications for medical research and embryo donation.Design-Ethnographic qualitative interview study. Setting-Academic research environment.Patient(s)-Fifty-eight couples who had conceived using a donor oocyte and had at least one frozen embryo in storage.Main Outcome Measure(s)-Tape-recorded interviews with 58 wives and 37 husbands were transcribed and analyzed for emergent themes.Result(s)-With an average of 7.1 embryos per couple, after an average of 4.2 years of storage, 72% of couples with frozen embryos had not reached a disposition decision. Most couples had not anticipated or appreciated the consequences of having surplus embryos. Parents variously conceptualized frozen embryos as biologic tissue, living entities, "virtual" children having interests that must be considered and protected, siblings of their living children, genetic or psychological "insurance policies," and symbolic reminders of their past infertility. Conclusion(s)-The disposition decision is not only a significant and frequently unresolved issue for couples with stored frozen embryos, but their deeply personal conceptualizations of their embryos contributes to their ambivalence, uncertainty, and difficulty in reaching a decision.

Donation of surplus frozen pre-embryos to research in Israel: underlying motivations

“…Contrary to other studies of the disposition decision that found a sense of resolution amongst their respondents [7], we found a lingering sense of discomfort and uncertainty amongst many of our respondents. This finding is in contrast to the altruistic motives cited in other studies by those who donated pre-embryos to research, and were less ambivalent about their decision than those who decided to destroy [17].…”

“…Although the decision to donate to research can have firm motivations – commonly described by donors as better than the thawing of embryos and as an opportunity to help others or to improve health and IVF treatments [3] – some reports have shown that as many as 88 % of couples who had originally chosen to donate their embryos to research changed their minds [7]. Yet there has been scant research on how patients who have stored frozen embryos actually think about them or what are their motivations and deliberations concerning the disposition decision [8].…”

Pregnant, Donor Oocyte Recipient Women Describe Their Lived Experience of Establishing the “Family Lexicon”

“…Noteworthy was that dimensions of the experience included descriptions of the interplay of religious beliefs and altruism. Although the indecisiveness in terms of embryo disposition described by some of the women may be attributed to the unknown outcome of their pregnancies, another qualitative analysis of donor oocyte recipient women and their husbands found 72% of them were undecided despite having cryopreserved embryos for 1 to 11 years duration ( Nachtigall, Becker, Friese, Butler, & MacDougall, 2005 ).…”

The decision-making process for the fate of frozen embryos by Japanese infertile women: a qualitative study

“…As with previous studies, reasons for not donating were lack of confidence in medical science [14,16]; the incomprehensibility [15] and inconvenience of the content of the research; and the embryo being recognized as a virtual sibling [9,12,14,18,24],]. As in Kato & Sleeboom-Faulkner’s study, we also found that the thought of dissecting an embryo or transforming it into another form was considered disrespectful by those opposed to donation [24].…”