Discarding IVF embryos: reporting on global practices
- 38 Downloads
To provide a global scale report on a representative sample of the clinical embryology community depicting the practice of discarding supernumerary IVF embryos.
A web-based questionnaire titled “Anonymous questionnaire on embryo disposal practices” was designed in order to ensure anonymous participation of practicing clinical embryologists around the world.
During a data collection period of 8 months, 703 filled-in questionnaires from 65 countries were acquired. According to the data acquired, the majority of practitioners, dispose of embryos by placing them directly in a trash can strictly dedicated for embryo disposal for both fresh and frozen cycles (39% and 36.7% respectively). Moreover, 66.4% of practitioners discard the embryos separately—case by case—at different time points during the day. Over half of embryologists (54%) wait until day 6 to discard the surplus embryos, while 65.5% do not implement a specially allocated incubator space as a designated waiting area prior to disposal. The majority of 63.1% reported that this is a witnessed procedure. The vast majority of embryologists (93%) do not employ different protocols for different groups of patients. Nonetheless, 17.8% reported the request to perform a ceremony for these embryos. Assessing the embryologists’ perspective, 59.5% of participants stated that the embryology practice would benefit from a universally accepted and practiced protocol.
This study uniquely provides insight into global embryo disposal practices and trends. Results highlight the divergence between reported practices, while indicating the significance on standardization of practice, with embryologists acknowledging the need for a universally accepted protocol implementation.
KeywordsSurplus embryos Embryo disposal practices IVF
We are very appreciative to all embryologists, clinicians, and scientists at the Department of Physiology of the National and Kapodistrian University of Athens Medical School, at the Centre for Human Reproduction at Genesis Hospital, and at the Assisted Conception Unit of the 2nd Department of Obstetrics and Gynecology at Aretaieion Hospital. The authors also thank Dr. Gerry Celia Laboratory Director and Assistant Professor at Jones Institute at Eastern Virginia Medical School in Norfolk for sharing the survey in order to reach embryologists on a global scale. Finally, we acknowledge the input of all practitioners taking the time to contribute to our survey by sharing their protocols and practices.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Vaughan DA, Leung A, Resetkova N, Ruthazer R, Penzias AS, Sakkas D, et al. How many oocytes are optimal to achieve multiple live births with one stimulation cycle? The one-and-done approach. Fertil Steril [Internet]. 2017 [cited 2019 Jan 6];107:397-404.e3. Available from: https://www.fertstert.org/article/S0015-0282(16)62960-6/abstract PubMedCrossRefGoogle Scholar
- 5.Siristatidis C, Vogiatzi P, Pouliakis A, Trivella M, Papantoniou N, Bettocchi S. Predicting IVF outcome: a proposed web-based system using artificial intelligence. Vivo Athens Greece. 2016;30:507–12.Google Scholar
- 9.Bruno C, Dudkiewicz-Sibony C, Berthaut I, Weil E, Brunet L, Fortier C, et al. Survey of 243 ART patients having made a final disposition decision about their surplus cryopreserved embryos: the crucial role of symbolic embryo representation. Hum Reprod Oxf Engl. 2016;31:1508–14.CrossRefGoogle Scholar
- 18.Dondorp W, De Wert G, Pennings G, Shenfield F, Devroey P, Tarlatzis B, et al. ESHRE Task Force on ethics and Law 20: sex selection for non-medical reasons. Hum Reprod [Internet]. 2013 [cited 2019 Feb 20];28:1448–54. Available from: https://academic.oup.com/humrep/article/28/6/1448/606259 PubMedCrossRefGoogle Scholar
- 30.Gurmankin A, Sisti D, Caplan A. Embryo disposal practices in IVF clinics in the United States. Cent Bioeth Pap [Internet]. 2004; Available from: https://repository.upenn.edu/bioethics_papers/7
- 38.Appleby JB, Bredenoord AL. Should the 14-day rule for embryo research become the 28-day rule? EMBO Mol Med. 2018;10.Google Scholar
- 41.McMahon CA, Gibson F, Leslie G, Cohen J, Tennant C. Parents of 5-year-old in vitro fertilization children: psychological adjustment, parenting stress, and the influence of subsequent in vitro fertilization treatment. J Fam Psychol JFP J Div Fam Psychol Am Psychol Assoc Div. 43, 2003(17):361–9.PubMedCrossRefGoogle Scholar
- 43.Williams JA, Meltzer D, Arora V, Chung G, Curlin FA. Attention to inpatients’ religious and spiritual concerns: predictors and association with patient satisfaction. J Gen Intern Med [Internet]. 2011 [cited 2019 Jun 3];26:1265–71. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208457/ PubMedPubMedCentralCrossRefGoogle Scholar
- 44.Millbank J. Reflecting the ‘human nature’ of IVF embryos: disappearing women in ethics, law, and fertility practice. J Law Biosci [Internet]. 2017 [cited 2019 Jun 3];4:70–93. Available from: https://academic.oup.com/jlb/article/4/1/70/2566734