Kristi Marshall had been through almost three years of fertility treatments, plus surgery for endometriosis, when her doctor gave her some bad news. She had very few eggs left and wasn't a good candidate for in vitro fertilization (IVF). "We were devastated," Marshall says. But she and her husband began to research conceiving using donor eggs and sperm. In the process, they learned about embryo donation—the chance to get pregnant using embryos that had been created and frozen by another couple.
A key difference: embryo donation cost a fraction of the price of her other options. According to the National Infertility Association, costs for embryo donation may range between $2,500 and $4,000, while the average cost of an IVF cycle is $12,400. And Marshall estimated using donor eggs and sperm would set her back about $30,000.
"We knew immediately that this was the route we should take," says Marshall, a dental hygienist in Dawsonville, GA. "Through the kindness of others we will be able to have a family of our own. We couldn't be more grateful."
Now pregnant with a baby girl due in October, Marshall is one of a growing number of prospective parents turning to embryo donation to start or expand their families. The practice is fueled by the hundreds of thousands of cryopreserved embryos being stored across the country, most left over from in vitro fertilization cycles.
How It Works for Donors
About a third of all IVF cycles result in extra frozen embryos, preserved because they could potentially be used in future cycles for the patients who created them, says Craig Sweet, M.D., medical director of Embryo Donation International, a Florida-based clinic that stores donated embryos, matches patients with embryos, and performs transfer procedures.
Patients who have finished having children have to decide what to do with these excess embryos. They can donate them to scientific research—including human embryonic stem cell research—dispose of them, or donate them to someone else looking to conceive.
"It's a very difficult decision," says Dr. Sweet. "If the family has had a child from that batch of embryos, they will sometimes look at the remaining frozen embryos as potential siblings to that child. They will look at those embryos as potential children. It might be very difficult for patients to donate their children for somebody else to raise."
But more families are making that decision. Embryo donation is on the rise: 1,042 donor embryo transfers were completed in 2013, up from 596 transfers in 2009, according to the Society for Assisted Reproductive Technology. The practice solves the issue of what to do with frozen embryos for families paying hundreds of dollars a year in storage fees, and it also fills a void for couples or single women still grappling with infertility.
How It Works for Recipients
"The process was just easy," Marshall says. "There's no waiting to see if the embryo was formed, like if you have an egg and sperm. Because the cells have already multiplied in a lab, you know it's a full-grown embryo waiting to be implanted."
Using a fertility clinic in Florida, Marshall and her husband looked through profiles of about 30 available donors that contained information about the parents' jobs and medical history, as well as how many births has resulted from the batch of embryos. They chose a single embryo created by a well-educated couple in their mid-30s—the batch had yielded two children.
Marshall began a regimen of tests and medication to prepare her body at home in Georgia, then traveled to Florida for the procedure. From choosing the embryo to the transfer, the process took just three months—and thousands of dollars less than their other options.
"The cost...was a big issue for us, and I think it is for a lot of people," Marshall says. "Most people have undergone thousands and thousands of fertility treatments and by the time they get to this phase they're exhausted financially."
It's true that embryo donation is often used by families who have tried to have children in many other ways. The average age of embryo recipients is older than IVF patients, egg recipients, or adoptive parents, according to Dr. Sweet. They're generally unable to reproduce with their own gametes, and so are considering other options like adoption. In fact, the practice is sometimes called "embryo adoption," but the American Society for Reproductive Medicine and many doctors prefer the term embryo donation because of legal differences between adoption and embryo donation.
Embryo Donation vs. Adoption
Like adoption, embryo donations can be closed, or anonymous, or open. The latter arrangement might allow the couple who created the embryos to have a say in who can use them and permit children born from donated embryos to later contact their biological parents. Some recipient families even stay in touch with donors throughout their children's lives, allowing donor-conceived children to have relationships with their full genetic siblings.
An essential difference from adoption is that a woman receiving donated embryos can actually be pregnant with her "adopted" child.
"The concept of carrying, nurturing, protecting, bonding, delivering, breastfeeding—these are tremendous advantages," Dr. Sweet says.
Experiencing pregnancy appealed to Maya Grobel Moskin, a psychotherapist and clinical social worker in Los Angeles. She and her husband had been through years of fertility treatments including intrauterine insemination and in vitro fertilization when a round of IVF with her sister's donated egg failed.
"We were really hoping that it would work," she says. "When it didn't, we were like 'What now?'"
They began researching frozen egg banks—which they'd heard were more economical—for another try with a donor egg when she came across embryo donation almost accidentally. Grobel Moskin found a pair of frozen embryos that matched her ethnic background at a fertility clinic in Seattle. She was told they were created using an egg donor and the sperm of an infertile couple and received health information about the egg donor and a photo of her as a child (less was disclosed about the sperm). The batch of embryos had resulted in one full sibling, plus the egg donor had her own children as well.
"It stuck with me," she says. "It was there already—a potential person."
After a few months, Grobel Moskin and her husband made the decision and traveled to Seattle for the transfer of one of the two embryos. Their daughter was born nine months later. After years of trying to conceive with the couple's own genetic material, the choice to use an embryo that was unrelated to them was a big one, she says.
"You have to really wrap your head around it," says Grobel Moskin, who blogs about her journey to start a family and is making a documentary about infertility with her husband. "But I have to say, I don't think about it. This is my baby. This is 150 percent my baby.... When you finally look at a child, you don't start piecing out the genetic stuff. It becomes so much less important."