December 13th, 2019

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Title:
The Fate of Supernumerary Cryopreserved Embryos: Insights into Patients’ Decisions
Authors:  Emerly Luong, B.S., Jody Lynee Madeira, J.D., Ph.D., Miryoung Lee, Ph.D., J. Preston Parry, M.D., M.P.H., Veerle Provoost, Ph.D., Guido Pennings, Ph.D., and Steven R. Lindheim, M.D., M.M.M.
  OBJECTIVE: To determine how patients’ decisions about supernumerary embryos are influenced by potential life events, including patients’ death and relationship dissolution.

STUDY DESIGN: A cross-sectional, quantitative survey study of patients who had undergone autologous in vitro fertilization (IVF) within the past 5 years. Questions evaluated decision-making about supernumerary embryos.

RESULTS: Of 249 subjects aged 22–50, 89% chose a disposition following death, and 77% following relationship dissolution. Following death, 58% preferred to allow partner use, compared to 32% after relationship dissolution. More participants preferred donation to research and were twice as likely to discard surplus embryos following relationship dissolution than death. Partners had different decisions 10% of the time. Income, IVF payment method, and number of IVF cycles were significantly associated with patients’ decisions. Compared with subjects making over $100,000 annually, those making $50–100,000 were 60% less likely to prefer partner donation following death. Those paying for IVF with personal savings were 2.4 times more likely to choose partner donation following death than relationship dissolution.

CONCLUSION: Death or relationship dissolution can translate into meaningful differences in patients’ decisions about supernumerary embryos. These findings demonstrate the complexity of decisions and how multiple factors affect this choice. Patients may benefit from counseling regarding dispositions’ ethical and legal implications.
Keywords:  embryo abandonment, embryo disposal, embryo disposition, embryo donation, fertilization in vitro, reproductive medicine, cryopreservation, counseling
   
   
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