Dr. Amelia Swanson, Ph.D.

Grief is a natural and common reaction to all kinds of loss; this includes the loss of or the threat of losing the chance to have children when diagnosed with infertility. Grief involves several emotional reactions to loss such as negative thoughts, a change in behaviors (e.g., difficulty sleeping), conflicting feelings, and challenging interpersonal experiences such as difficulty attending baby showers or other child-focused activities.

Grief related to infertility affects many areas of a person’s life. Infertility-related grief can include sadness, anger, anxiety, shock, feeling invisible, feeling like no one understands your experience, emotional numbness, loneliness, and/or difficulty engaging in daily life.ⁱ Fertility issues can also impact self-esteem.^ii,iii Although infertility-related grief can sometimes be long-lasting, feelings of grief generally decrease over time.

Pregnancy loss is a relatively common, often heartbreaking outcome of pregnancy. Statistics on the prevalence of pregnancy loss are variable, though estimates suggest that between 10-30 percent of pregnancies will result in a miscarriage.^i,ii,iii,iv The chance of miscarriage increases based on age and other factors.^v Between 0.2-2.78 percent of pregnancies worldwide will end with stillbirth, which is the loss of a baby after 20 weeks' gestation (24 weeks is the cut-off definition for stillbirth in some regions).^vi,vii,viii Fewer than 0.3 percent of infants die before their first birthday in Western nations.^ix,x  

While losses may be common, each loss is unique, and each person will experience loss differently. The journey through grief can feel lonely, but there are things that can help people navigate towards healing.  

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Following an IVF cycle, any resulting embryos that are not transferred to the uterus (fresh transfer) are frozen, or cryopreserved. These frozen embryo(s) will remain frozen until the patient is ready to transfer them (called frozen embryo transfer). However, sometimes there are surplus embryos after the patient has completed their family, or plans change, and embryos remain unused for many reasons. Hundreds of thousands of surplus frozen embryos are currently stored at fertility clinics worldwide – that is, embryos created for fertility treatment and then are not needed by the person(s) that created them.

When a person has frozen embryos in storage that they do not plan to use, it can be difficult to decide what to do with those embryos. When people begin their IVF journey, they may not consider that this is something they may need to think about in the future. Alternatively, if they have considered this, their thoughts on what they plan to do with any unused embryos may have changed. This article outlines the logistical and emotional considerations for the four main options for additional or unused embryos: donation (to medical research, or to another family), destruction, compassionate transfer, and perpetual/indefinite storage.^i,ii,iii

This article will look at broad outlines, practices, and legislation, which do vary depending on where someone lives. Some countries have comprehensive regulations surrounding the handling of surplus embryos, including guidelines on informed consent and storage limits, while others have fewer rules in place, which leaves the decision largely down to clinics and individuals.^iv,v,vi

A Reproductive Endocrinology and Infertility (REI) specialist or fertility clinic can provide more information on local regulations surrounding the options for unused embryos.