When people walk into an IVF cycle, the conversation is almost entirely about how to make embryos and how to get one of them to stick. The question of what happens to the embryos you don't transfer is usually a single line on a consent form: storage, donation to another family, donation to research, or thaw and discard. Sign here.
Years later, that line on the form turns out to have been one of the hardest decisions of the whole process — and one most parents end up not making at all. The most common outcome of an IVF cycle that produces extra embryos is that the embryos sit in storage indefinitely, while the parents pay an annual fee and try not to think about it. Researchers who study this have a name for it: embryo limbo.
This piece walks through what the options actually are, what the legal landscape looks like in 2026, what the costs are, and what the published research shows about how parents feel about each option years later. It is not a recommendation — there isn't a right answer. It's the conversation IVF clinics often don't have time for.
How many embryos are we talking about
In the US, somewhere between 380,000 and 450,000 ART cycles are reported to SART each year (SART National Summary Reports, 2020s). A meaningful fraction of those cycles produce more viable embryos than the family will transfer. The most-cited national estimate of total embryos in US cryostorage came from a RAND survey by Hoffman and colleagues in 2003, which counted about 400,000 frozen embryos at the time (Hoffman et al. 2003 Fertility and Sterility). Two decades of higher cycle volumes and the shift toward freeze-all protocols means the current number is much larger; estimates in the reproductive-medicine literature now place it well above one million, though no one has done a true national census since the RAND study.
The practical point: this is not a fringe issue. Hundreds of thousands of US families are quietly storing embryos and putting off a decision, and tens of thousands more join them every year.
The five options, in plain terms
Most US clinics present some version of the following choices on their disposition consent. Different clinics word them differently, but the underlying menu is fairly standard (ASRM Ethics Committee, Disposition of Abandoned Embryos, 2021).
- Continued storage. The embryos stay frozen at the clinic or a third-party long-term storage facility. You pay an annual fee. This is the default and, in practice, what most families end up doing for years.
- Transfer to self or partner. You attempt another pregnancy yourself, either now or later. The frozen embryo transfer (FET) success rate is broadly comparable to fresh transfer in modern cycles.
- Donation to another family. The embryos are released for use by another patient or couple — sometimes anonymously, sometimes through an open or "matched" arrangement that resembles open adoption.
- Donation to research. The embryos are released to a stem-cell or reproductive-biology research program. They are not implanted; they are studied and ultimately destroyed.
- Thaw and discard. The embryos are removed from cryostorage and allowed to perish. Some clinics offer a "compassionate transfer," in which the embryos are placed in the uterus at a time in the cycle when implantation cannot occur, so the body resorbs them rather than the lab discarding them.
On paper these are five choices. Emotionally and legally they are not equivalent, and the published research suggests parents experience them very differently.
What it actually costs to do nothing
Annual cryostorage fees in the US typically run somewhere between $500 and $1,500 per year, depending on the clinic and whether storage is on-site or at a dedicated facility (ASRM patient education materials; clinic disclosures). Some long-term facilities offer multi-year prepay discounts. Storage for ten years can easily exceed $10,000.
There is also a quieter cost: clinics regularly lose contact with patients. The ASRM Ethics Committee opinion on abandoned embryos (2021) describes a fairly common pattern — patients move, change phone numbers, stop responding to letters, sometimes for many years. Most clinic consent forms specify a procedure for embryos deemed "abandoned" after a defined period of non-payment and non-contact, usually involving a final attempt at certified mail and then disposal under the terms the patient originally signed. In practice this means a meaningful share of stored embryos are eventually discarded by clinics with no further input from the families who created them. The decision was effectively made by not making one.
The legal landscape after Dobbs
For most of the history of US IVF, frozen embryos sat in a fairly stable legal category: property, with special characteristics, governed primarily by clinic contracts and family law (custody disputes between divorcing couples, mostly). Dobbs v. Jackson Women's Health (2022) returned abortion regulation to the states, and a handful of states have since taken the further step of treating embryos — including embryos outside the body — as legal persons or "children" for at least some purposes.
The most consequential ruling so far is LePage v. Center for Reproductive Medicine, Inc., decided by the Alabama Supreme Court on February 16, 2024. The case arose from a 2020 incident in which a patient at an IVF clinic wandered into the cryostorage area and dropped several frozen embryos, destroying them. The plaintiffs sued under Alabama's 1872 Wrongful Death of a Minor Act. The Alabama Supreme Court held that the statute applies to "all unborn children, regardless of their location," explicitly including embryos held outside the body in cryostorage. In effect: extrauterine embryos are children for Alabama wrongful-death purposes (LePage v. Center for Reproductive Medicine, Inc., No. SC-2022-0515, Ala. 2024).
In the weeks after the ruling, several Alabama IVF clinics paused operations because they could not assess their liability exposure for routine procedures (thawing, biopsy, transfer, discard). The Alabama legislature passed a narrower civil and criminal immunity statute for IVF providers shortly after, which restored most clinical activity but did not overturn the underlying legal classification of the embryo.
No other state supreme court has gone as far as Alabama, but several states have personhood language in their constitutions or statutes that lawyers and clinicians are watching carefully. Louisiana has long had a statute defining an in vitro embryo as a "juridical person" with limited rights. The practical effect for patients is that the legal status of stored embryos can now depend meaningfully on the state in which they are stored — and the rules in that state can change while you are still deciding.
None of this is legal advice and none of it tells you what to do. But it is worth knowing before you sign a disposition form that the legal default in your state may not be the one in place when you eventually act on it.
Donation to another family — the version most people don't expect
On the consent form, "donation to another family" looks like a parallel choice to "donation to research." In practice it is a much more involved process and a much rarer outcome.
Studies of disposition decisions consistently find that intended donation to other families is far more common than completed donation. A meaningful share of patients who initially say they will donate change their minds when the time comes (Provoost et al. 2012, Human Reproduction; Goedeke & Daniels 2017). The reasons are familiar once you hear them: parents start to think of the frozen embryos as full siblings of the children they have, and giving away a "sibling" feels different from giving away a cell cluster.
For families who do donate, the process typically involves: matching through the clinic or a third-party agency, infectious-disease screening of both genetic parents (often re-screening, since FDA tissue rules apply), genetic and medical history disclosure, psychological evaluation of both parties, and a legal contract addressing parental rights and any future contact between the donor family and any child born from the embryos. Costs to the recipient family are substantial; donor families generally do not receive payment, and many states prohibit it.
Open versus anonymous arrangements are now mostly a fiction in the era of consumer DNA testing. Donor families considering anonymity in 2026 are usually told plainly: assume any child born from these embryos will eventually be able to identify you.
Donation to research
Research donation is logistically simpler than donation to another family but has its own constraints. Embryos donated to research cannot later be transferred to anyone — research is, in this sense, terminal. Stem-cell programs and developmental-biology labs use donated embryos to study early development, model disease, and improve IVF technique itself. Federal funding for embryonic stem-cell research has been politically contested for two decades; many programs run on private or state funding.
The interview literature suggests families who donate to research often feel better about the decision than those who donate to other families, because the embryo is not "becoming a child somewhere I can't see" (De Lacey 2007, Human Reproduction; Provoost et al. 2012). For some, contributing to science feels like the embryos' creation served a second purpose. For others, "destroyed in research" is harder than "destroyed at the clinic."
Thaw-and-discard, and "compassionate transfer"
The most direct option is also, for many patients, the hardest to commit to. Thaw-and-discard means the embryos are removed from cryostorage and allowed to perish in the lab. It is what happens, ultimately, to most embryos donated to research after the research is complete, and it is what happens to abandoned embryos under most clinic protocols.
Some patients ask their clinic for a "compassionate transfer" instead — an embryo transfer scheduled for a point in the cycle when implantation is biologically impossible, with the understanding that the embryo will be resorbed by the body rather than discarded in a dish. The ASRM Ethics Committee has discussed this practice in its disposition guidance and finds it ethically permissible, though it notes that not every clinician will offer it and that the language used in the consent process matters. For some patients, particularly those with religious frameworks that emphasize the dignity of the embryo, compassionate transfer makes a decision they couldn't otherwise make feel possible. For others, it feels like a euphemism. Both responses are well-documented in the qualitative literature.
Why most parents pick none of the above
Across multiple countries and study designs, the single most consistent finding in the disposition-decision literature is that parents defer. They keep paying. Studies in Australia, the UK, Belgium, the Netherlands, and the US converge on similar numbers: when surveyed years after their last fresh cycle, a majority of parents with stored embryos have not made a final decision, and many have already paid for storage longer than they originally expected to (De Lacey 2007; Provoost et al. 2012; Goedeke & Daniels 2017; Nachtigall et al. 2010 Fertility and Sterility).
The qualitative interviews reveal something that the consent form misses: many parents come to think of the stored embryos not as cells, and not as children, but as something specific to their own family — "potential siblings," "what could have been," "our future twins if we change our minds." De Lacey called the phenomenon "virtual children." Once that frame settles in, every option on the menu starts to feel like a loss, and indefinite storage starts to feel like the only option that doesn't require grieving.
There is no evidence that deferring causes lasting harm to parents — many people live with this decision unmade for the rest of their reproductive lives and feel fine about it. But it is worth knowing, before you start, that "I'll figure it out later" is the most likely thing that happens, and that "later" can mean ten years and ten thousand dollars.
What religious and philosophical traditions actually say
For families whose decision will be shaped by a religious framework, the major positions are clearer than the secular ones. We'll describe them flatly.
Catholic teaching, articulated in Donum Vitae (Congregation for the Doctrine of the Faith, 1987) and reaffirmed in Dignitas Personae (2008), opposes IVF itself and considers the embryo to have full human dignity from the moment of fertilization. Frozen embryos are described in Dignitas Personae as being in "a situation of injustice." Donation to other families and donation to research are both rejected; the document acknowledges no fully ethical disposition option for embryos that already exist, while opposing the creation of more.
Mainstream Protestant traditions are more varied. Many denominations consider IVF and disposition matters of conscience, with significant differences across evangelical and mainline communities.
Mainstream Jewish bioethical positions, across Orthodox, Conservative, and Reform movements, generally support IVF as consistent with the obligation to be fruitful, and most authorities allow research donation and disposal of unused embryos, with the embryo treated as having developing rather than full personhood before implantation. The specifics vary by posek and movement.
Mainstream Islamic bioethics, in both Sunni and Shia traditions, generally permits IVF within marriage but is more restrictive on third-party donation. Most authorities discourage embryo donation to other families; research donation is debated.
Secular bioethics is genuinely pluralistic. Most major bioethics frameworks treat the embryo as morally significant but not equivalent to a born person, and treat the parents' decisional authority as paramount within reasonable constraints. Beyond that there is no consensus, and there is unlikely to be one.
What practitioners suggest you think about before freezing extras
Across the literature, a few practical recommendations come up repeatedly from clinicians and counselors who do this work (ASRM Ethics Committee guidance; Nachtigall et al. 2010; clinic patient-education materials).
- Have the conversation with your partner before retrieval, not after. Once the embryos exist, the decision is harder. Discuss what you'd each want in the most likely outcomes (you complete your family with one transfer; you complete it with several; you don't end up using any).
- Decide how many embryos you actually want to create. Many clinics now offer single-blastocyst transfer with planned freezing of supernumerary embryos, but you can also discuss a more conservative retrieval-and-fertilization plan with your reproductive endocrinologist if creating fewer extras matters to you.
- Read the disposition section of the consent form carefully and ask what happens in specific scenarios: divorce, death of one partner, death of both, loss of contact, clinic closure, clinic sale. The defaults vary.
- Ask the clinic to walk you through their abandonment policy. If you forget about the embryos in fifteen years, what do they actually do? When?
- Pick a state-of-storage you're comfortable with. Long-term storage facilities operate across state lines; the legal classification of an embryo can depend on where it physically sits, not where you live.
- Revisit the decision every few years. The right answer at 35 with no children is often not the right answer at 42 with two.
None of this prevents the decision from being hard. It just keeps it from being made by accident, in a hurry, on the same form where you sign about anesthesia.
A note on the emotional shape of this
The hardest thing about embryo disposition is that the language we have for it is mismatched to the experience. The clinic talks about cellular material, cycles, and consent forms. The legal system, depending on the state, talks about property or about children. Religious traditions talk about dignity, ensoulment, or potential. None of these match the lived feeling, which is more often something like: a small, frozen, possible version of our family is waiting in a tank in a building in another state, and I have to decide what to do about it, and there is no answer that doesn't hurt.
That is genuinely the situation. Recognizing that the discomfort isn't a sign you're making the wrong decision — it's a sign you're taking the decision seriously — is, for many parents, the most useful single thing.
Sources
- LePage v. Center for Reproductive Medicine, Inc., No. SC-2022-0515 (Ala. Feb. 16, 2024).
- ASRM Ethics Committee. Disposition of abandoned embryos: an Ethics Committee opinion. Fertility and Sterility, 2021.
- Hoffman DI, Zellman GL, Fair CC, et al. Cryopreserved embryos in the United States and their availability for research. Fertility and Sterility, 2003;79(5):1063-1069.
- SART National Summary Reports. Society for Assisted Reproductive Technology, annual.
- Provoost V, Pennings G, De Sutter P, et al. Patients' conceptualization of cryopreserved embryos used in their fertility treatment. Human Reproduction, 2012;27(3):705-713.
- De Lacey S. Parent identity and "virtual" children: why patients discard rather than donate unused embryos. Human Reproduction, 2005;20(6):1661-1669.
- Goedeke S, Daniels K. The discourse of gifting in embryo donation. Human Reproduction Open / Reproductive BioMedicine & Society Online, 2017.
- Nachtigall RD, MacDougall K, Lee M, et al. What do patients want? Expectations and perceptions of IVF clinic information and support regarding frozen embryo disposition. Fertility and Sterility, 2010;94(6):2069-2072.
- Congregation for the Doctrine of the Faith. Donum Vitae (1987); Dignitas Personae (2008). Vatican.va.
- Dobbs v. Jackson Women's Health Organization, 597 U.S. 215 (2022).