Choosing Embryo Adoption - Is it right for me?
Eligibility - Am I a Good Candidate?
The Process - How Does Embryo Adoption Work?
Costs and Funding
Matching
Legal Aspects
Frozen Embryo Transfer | Medical Aspects
Adoption Success - How Successful is Embryo Adoption?
Couples and singles who adopt embryos may be
    • Worried about male or female infertity
    • Concerned by a high risk of passing on genetic disorders
    • Frustrated with recurrent IVF failures
    • Feeling pressured to find an alternative to fertility treatments such as IVF or donor egg recipient IVF
    • Discouraged by the costs of IVF or other methods of treatment
    • Nervous about the cost and emotional exhaustion often associated with adopting a newborn in the USA or overseas
    • Or simply drawn to adoption as a means of bringing a family's love to a child in need.
Now you can fulfill your desire for a family, give birth to the very child you adopted as a frozen embryo and ensure that a precious life is preserved at the same time. Surrogacy is also an option that many families find more affordable or possible to pursue when adopting embryos.

The most obvious difference between an embryo adoption and a traditional adoption is the pregnancy experience. Adoptive mothers are able to experience the joys (and challenges!) of pregnancy and childbirth. They also have peace of mind knowing their children received the appropriate prenatal care and were not exposed to alcohol or drugs during pregnancy.

There are certain considerations involved in embryo adoption that are not present in traditional adoption. For instance: Embryo adoption does not 'guarantee' a live birth. When more than one embryo is transferred, an adoptive couple might have twins or even triplets.

Parents who adopt embryos are able to begin the bonding process with their child before they are born. They are giving embryos who have been frozen an opportunity for life. The embryos belong to the adopting parents before they are placed in the womb and the donating parents have relinquished all parental rights. The child born to the adopting couple is their legal child.

Embryo adoption is just one of several family building options. Couples should evaluate the pros and cons of all of the adoption alternatives available to them and make the choice that is right for their family.

Most available newborns do not wait for adopting parents, whereas parents frequently wait for available newborns. The parents who would pursue embryo adoption may have already researched their options surrounding the adoption of an infant. If newborns were available at the same rate as embryos, many adopting families would most likely take the child already born, since there is no guarantee of a pregnancy with embryo donation and adoption. However, there are many families for whom the possibility of being able to experience pregnancy is a crucial factor in their decision to pursue embryo adoption over traditional adoption.

It is also important to keep in mind that some families have a preference for adopting children over a certain age or are interested in adopting sibling group. Others are more interested in working through the foster-adopt system. Embryo adoption is simply another choice available to families who are interested in adopting a child—albeit much earlier in the child's biological development.

Embryo donation programs are generally managed by fertility clinics, which receive donated embryos to be given anonymously to whomever the clinic chooses. Because these programs tend to be anonymous, clinic embryo donation programs will not provide any personal information about the donor family, only their medical background. There is no contact between the families before or after the birth, even through an intermediary. The clinic is only required to keep records of the donation for seven years and additional information about the donor family is typically not released, even in the event of a medical emergency.

Some clinics do offer a designated [open] donation program, giving the donating family the option of choosing the receiving family and they can mutually determine the level of future interaction between families. There are websites that assist donating and receiving families to privately match with one another, establishing a context for a known donation.

Adoption programs regard embryo donation as equivalent to a traditional adoption process since the hoped for outcome is the birth of a child. The adoption agency provides the same safeguards that the traditional adoption process offers, allowing you access to important information about the genetic family that can help your child answer their questions about their origins. You also have the opportunity to have a relationship with your child’s genetic family. Whether you exchange pictures and letters, have telephone conversations, or choose to meet the genetic family, you will know that you have access to information about your child’s history. The agency may also be available to facilitate communication between the families and to coach you on how to talk to your child(ren) about their unique conception and adoption-related issues.

Typically, placing or donating parents tend to use the term 'donation', while receiving or adopting couples tend to use the term 'adoption'. The basis for this is largely psychological. Donation is used in the sense of 'giving a gift' and offers an emotional separation from the embryos that the phrase 'placing for adoption' does not. Yet for the family wanting to parent the children born from such a gift, the term 'adoption' makes more emotional sense. It is the term that both legally and socially explains the transfer of parental rights associated with traditional adoption. Adoption also helps to describe and explain to their child the way in which they became a family, since children are 'adopted' rather than 'donated'. Frequently the terms are used interchangeably like the words lawyer and attorney.

Adoption agencies have proven processes, legal contracts, counseling and educational programs in place to guide families through receiving embryos. An adoption agency is focused not only on assisting their client in building their family, but in providing them with appropriate social/emotional education to support them before and after the adoption is completed.

An adoption agency with an embryo adoption program recognizes that the hoped for end result of embryo adoption is the birth of a child, a child who is not genetically related to you. Adoption agencies have the experience to enable and educate families how to successfully help a child understand their origins and their beloved place in their family.

Another benefit of embryo adoption is the adopting family has a chance to have a relationship with their child's placing family. Whether they share pictures and letters, have telephone conversations or choose to meet the placing parents, the adopting family will know that they have access to information about their child's history, as well as for any future medical need. The agency is available to facilitate communication between the families. The agency will educate and work with the adoptive family about how to talk to their child(ren) about their unique conception and adoption-related issues.

  1. Learn for yourself about embryo adoption.
  2. Visit with people who have adopted embryos. Check out blogs and forums posted by embryo adopters. Watch testimonial videos on this site and on YouTube.
  3. Ask yourself if you are willing to take the risks involved: Are you willing to accept the financial risk? Are you alright with having a child that may not resemble you? Will you accept the child even if it is born with disabilities?
  4. Talk with your OB/Gyn and a local reproductive endocrinologist.
  5. Contact embryo adoption agencies and determine which one offers a program to meet your needs OR determine if you would rather pursue donation through a clinic program.
  6. Ask yourself if you are willing to complete a home study. A home study will be a requirement if you receive embryos through an adoption agency program.
  7. Ask yourself about your preferences for a match with a donor family. Do you want to be able to know who the family is? Have a say in who you receive embryos from?
This is not a comprehensive list, but should set you on the right path for determining if embryo adoption is the right choice for you.

Under current US law, the term "adoption" only applies to the placement of a child after they are born. In the U.S., the placement of embryos into an adopting family is governed by property law. While adoption law itself is not applicable to the embryo donation/adoption process, embryo adoption agencies will apply the best practices of the adoption process because the end result is the birth of a child. The adopting parents' relationship with the child(ren) is just as binding as a legal adoption. Experienced embryo adoption agencies will have legal documentation for both parties that have successfully been used by many matched families.

Experienced embryo adoption agencies will have legal documentation for both parties that have successfully been used by many matched families. In some states, such as Kansas, Missouri and Georgia, the adoption of embryo children may be finalized in the courts (although it is not required).

The simple answer is that it is less expensive. 'Donated' eggs can cost $10,000 - $50,000+. Eggs are purchased, embryos are donated.

Another consideration is the fact that there are more than 600,000 embryos in frozen storage in the United States today. Obviously all of these embryos are not available for adoption, yet each year more families are choosing to donate remaining embryos to other people either through their clinic or through an adoption agency.

Choosing to purchase eggs from a donor to create more embryos may simply add to the number of embryos in frozen storage after you have completed building your family.

In surrogacy, an agreement is made for embryos to be transferred into a woman's uterus, and she carries the pregnancy for the benefit of the intended parents. The intended parents are specifically making embryos in vitro for placement into the surrogate using either their own genetics or purchased donor genetics. Or, the surrogate may be impregnated using artificial insemination using the intended father's semen and her eggs. Surrogacy laws exist in each state and may differ by state.

Compare that to embryo adoption and donation, where the adopting mother herself carries the child or children. The placing couple relinquishes their rights to any children born from the embryos prior to the transfer of those embryos into the adoptive mother's womb. The child that the adopting mother carries and gives birth to is the child that she and the adopting father will parent.

An anonymous donation occurs when donors and recipients do not know one other's identities. No contact is made between the donor or recipient, either now or in the future. Anonymous donation most often takes place through a fertility clinic, but may be facilitated by an adoption agency.

Most clinics that have an embryo donation program provide very limited information to the recipients about the donors. Donors are rarely involved in the process of selecting recipients, but are sometimes permitted to set stipulations for eligibility to receive their donation. Medical information about the donated embryos is provided to the recipient.

At first the concept of embryo adoption might be a bit overwhelming. The good news is that many couples have found embryo adoption to be the answer for adding children to their lives.

Step One is to learn as much as you can and then determine if you would prefer to work through an agency adoption program, a clinic donation program or attempt a direct match.

Continue to look through our website to gain more information on embryo donation and adoption and to hear from other people who have been donors or recipients. The Personal Stories section includes people's experiences with donating or adopting embryos.

Our Videos inform about frozen embryo adoption and portray the decision-making process of donating and adopting families.

There is also a list of Articles on embryo adoption. If you decide to adopt embryos you can find a list of agencies with embryo adoption programsa list of agencies who provide embryo adoption home study services and a list of clinics who have embryo donation programs.

Questions? Contact us and we'll do our best to answer them!

We recommend that you learn to communicate very well about complex issues, surround yourself with others who are learning about similar issues, and find professional support that can encourage and support you in positive and wise ways. Finding a counselor who has in-depth experience with the psychological impacts of infertility is a good first step.

Even for those families who choose embryo adoption without having experienced infertility, counseling is still recommended. Choosing to parent through embryo donation involves a leap of faith that you will be able to handle the multiple uncertainties that you might face.

If you've already faced infertility, you know first-hand how it can take a toll emotionally, financially, sexually, and spiritually on both the individual and the couple. We suggest that you grieve the many losses involved in your infertility, openly share your feelings with each other and forgive each other for the misunderstandings you experienced during the treatment period. Doing so will set you up to be in a place of strength to begin your embryo adoption journey.

Keeping in mind that the hoped-for end result is the birth of a child, coming to conclusions regarding how you will educate that child about their origins is also important.

Becoming a parent is a life-changing experience like no other. Regardless of where your children come from or how they were conceived, parenting is both the most rewarding and the most challenging life experience you will ever have.

No. Some programs will not allow for couples who do not have an infertility diagnosis to participate, but many are welcoming of couples regardless of their reasons for choosing embryo adoption as their family building path. Couples who are simply interested in adding children to their family through adoption pursue this option with some regularity. We've also known of families who wish to avoid passing on a genetic condition who end up deciding on embryo adoption as a life-affirming way to build their family.

Embryo adoption may also be a viable alternative for single women to achieve pregnancy using embryos that have already been created.

Each embryo adoption program will have its own unique requirements for families seeking to adopt embryos. Generally speaking, however the adoptive family must meet the following two requirements:

  1. The adopting mother must be able to carry a child to term. Her doctor will be asked to provide a letter stating that there are no contraindications to pregnancy [no medical reason that will prevent her from carrying a pregnancy to term]. Some agencies will allow surrogacy in the event that a woman cannot carry a pregnancy.
  2. The adopting family must also have completed an adoption home study if working with an agency. Fertility clinic embryo donation programs will generally require psychological evaluations.

Many adoption agencies also have requirements such as the adoptive family's age, marital status or marriage length. It's also important to keep in mind that many agencies will match adoptive families to genetic families based on the genetic family's criteria and may recommend that an inquiring family pursue an alternate program based on how long the agency believes the family may have to wait for a match based on both their situation and their desires regarding the donor family and their embryos.

Legal contracts are generally provided by the adoption agency. If the family chooses to work directly with a clinic with a donation program or directly with a donor, they should be sure to complete legal contracts releasing the embryos to their ownership prior to the frozen embryo transfer.

Each adoption agency has various eligibility requirements for adopting parents. These include, but are not limited to:
  • An age limit for the adopting mother
  • Length of time married
  • Eligibility of couples who do not have an infertility diagnosis
  • Eligibility of single women
  • Eligibility of homosexuals
  • Out-of-state embryo adoptions
  • Out-of-country embryo adoptions
  • Whether adoptive couples can use a surrogate mother to carry their adopted embryos
  1. The first step in embryo adoption is to check with your OB/Gyn to see if you are able to carry a pregnancy to term.
  2. Evaluate the embryo adoption providers and select the agency/organization you would like to partner with for your adoption.
  3. Complete the agency's application.
  4. Select a clinic/physician for the medical procedures.
  5. Select a home study provider and complete a home study.
  6. Review matches presented by agency and agree to a match.
  7. Complete legal contracts.
  8. Embryos ship to chosen clinic.
  9. Schedule frozen embryo transfer(FET)with physician.
  10. Wait approximately nine months for a baby.
A list of agencies and organizations who offer embryo adoption services is available on this website. When researching your alternatives here are some things to consider:
  • Do you want to choose your own physician? Some programs require you to use the clinic which operates or is in partnership with the embryo adoption process.
  • Some programs are centralized, one-stop shops which may be your best alternative. Everything is managed from one central location. Additional expenses for traveling to the centralized site should be included in your cost calculations.
  • How long has the program been established?
  • Do they have any special requirements?
  • What do their legal contracts include? Are you able to make changes to them to meet your desires?
  • What is the estimated time frame for being matched and giving birth?
  • How comfortable are you with the people in the agency with whom you will be working?
  • What exactly does each of the fees charged by the agency include? Matching? Legal contracts? Shipping coordination and costs? Additional medical testing? Home study? Medical costs?
(This is not an all-inclusive list of questions to ask.)
Each adoption agency and embryo adoption program is different. An adoptive family should check with both the adoption agency and embryo adoption program to determine if this is allowed.
After you have submitted your application to an adoption agency you will need to complete a home study (unless you have completed one within the past 12 months). On average it will take about six to thirteen months to match you with a donor family and assist you in completing the necessary legal and administrative steps to get the embryos shipped to your fertility clinic. The length of time will vary based on many factors including: your age, the preferences you specified on your application for the donor family, and specifications you and your reproductive endocrinologist may have regarding the embryos you are matched with.
A few questions you may want to consider asking when looking for a fertility clinic are:
  • Is the clinic willing to accept embryos from another clinic for a frozen embryo transfer (FET)?
  • How much does it cost for a FET, including necessary prescriptions?
  • Does the clinic have any testing or screening requirements?
  • Are there any other conditions involved in accepting and transferring the embryos?
  • What are the in-house statistics regarding thawing and transfer of embryos?
  • What paperwork is required by the clinic? How long will it take the clinic to process the paperwork?
  • What are the short-term and long-term storage fees at the clinic?
  • Check the Center for Disease Control statistics on the clinic to see not only their pregnancy rate, but also their live birth rate, and multiple birth rate.

The importance of the home study lies in its purpose to help couples have not only healthy children, but healthy families.

An adoptive home study for the recipient couple ensures that the safeguards currently in place for traditional adoption also protect the child, the placing parents and the receiving parents in an embryo adoption situation.

Despite the fact that the adoptive mother gives physical birth to a child from an embryo donation, that child is still an adopted child; he or she shares no genetic relation to the adoptive mother or father. When children are born into a family to whom they are not genetically related, they may have the same types of questions as those of children adopted through traditional means. The home study process includes both education and back-ground checks. It provides the adoptive family with an opportunity to learn about and anticipate these types of issues and questions. The home study also educates the parents of the best way to address and answer these questions with sensitivity to the needs of the child.

The home study process benefits donating parents by assuring them that the adopting family:

  • was evaluated for any health issues that may affect their ability to care for and raise a child,
  • was screened for any criminal and child abuse issues,
  • was educated concerning the potential issues of parenting a non-genetically related child
For most embryo adoption programs, a traditional domestic home study with some modifications is all that is required. It is best to find a private licensed adoption agency to work with because most state agencies or social services departments do not perform pre-placement home studies, and the ones who do most often will not provide a copy to an outside agency. A list of agencies in your area offering embryo adoption home studies can be found on this website.

If a licensed home study is completed it may be used for another adoption program with modifications. An adopting family should discuss this option with their social worker while still in the home study process.

If you have already completed your home study, you should be aware that there are time limits regarding the validity of a home study. Check with your agency to see if your home study is still valid or requires updating. Your embryo adoption agency may be able to use your current home study provided that it will remain valid through the completion of your embryo adoption. Many agencies will require you in those cases to complete additional education specific to embryo adoption in order for your home study to transfer.

This is a common question asked by embryo, sperm and egg donors. The risk is negligible according to published guidelines and basic statistics. If one couple donates cryo-preserved embryos, the chance of accidentally meeting and being intimate with a sibling is extremely unlikely. Donating embryos to someone in a different state will further minimize the risk. Donating embryos in an open embryo adoption is the best alternative to virtually eliminate this risk.
Several embryo adoption programs will allow you to choose the fertility clinic you wish to work with for your medical procedures. Others will require that you use a particular clinic. Most clinics with donor programs will require you to use their clinic. Understand your priorities and then select the right program for you.

Embryo adoption is a low-cost adoption alternative when compared to domestic and international adoption, repeated IVF cycles and the cost of donor eggs. While the embryo donor does not receive payment for their embryos, there are administrative, legal and embryo shipping costs associated with the process that are paid by the adoptive family. Additionally, the adoptive family's fees will often cover the costs of the required FDA bloodwork and screening for the genetic family.

The total cost of your embryo adoption will vary, based on the providers you work with for the adoption facilitation, home study and frozen embryo transfer.

Embryo adoption costs are primarily paid by the adopting family. Generally the donating family does not receive payment for their donation nor should they expect the recipient family to cover any of the IVF expenses they had previously incurred. Embryo storage costs prior to the match are also the responsibility of the donor family. The recipient family may be asked to pay for storage fees after the match is made.
Agency Fee* *Additional travel expenses may be incurred for centralized programs. $2,500-$10,000 May or may not include legal fees, embryo shipping, matching services, counseling, additional medical screening
Home Study/Family Evaluation $1,500-$3,500 Costs vary by state
Clinic Frozen Embryo Transfer (FET) $3,500-$6,000 Costs vary by clinic
TOTAL $7,500-$19,500 Generally less expensive than domestic or international adoption
     
 

An embryo adoption program's fees typically cover preparing the adoptive family to enter the matching phase of the program, helping them build a family profile, coordinating with the adopting family’s clinic of choice regarding the receipt of embryos created at another clinic, matching of the adopting family with a donating family, maintenance of files, facilitation of communication between donating and adopting families, preparation of contracts, relinquishments and other legal paperwork, counseling for both sides, coordination of communication between clinics and doctors to ensure that requirements are met for the transfer of the embryos between states, and management and direction of shipping of the embryos.

The program fee may also cover the costs associated with preparing the donating family to enter the matching phase of the program which entails helping the placing family obtain the required FDA bloodwork and preparing a comprehensive medical background and often biographical information to be shared with the adoptive family.

Home study, medical and incidental expenses are generally not included.

This depends on the program you are working with. If medical expenses are included in the fee, generally you will need to work with a specific fertility clinic. If medical expenses are not included, adopting parents are often able to choose their fertility clinic and doctor. Adopting parents are responsible for paying the clinic to thaw and transfer the embryos as well as any other associated medical costs connected with the transfer. When choosing a fertility clinic, be sure to compare like services included in various quotes and the costs of subsequent transfers and embryo storage.
Costs which may not be covered by an embryo adoption program include the rental of a dry shipper for the embryos’ travel and additional lab tests for a donating family or rarely, storage fees incurred by the donor family after the match is completed.

Typically, adopting families do not reimburse the donor for any expenses that accrued prior to having been matched. Adopting families do often reimburse donating families for any expenses incurred after they are matched. This includes storage and shipping fees, legal costs, and any fees associated with medical or psychological screening.

These may be included in the overall program fee if done through an agency. Any sort of direct compensation for the embryos themselves is under the legal jurisdiction of each state, and interested parties should seek legal advice to determine the applicable laws in their states. In general, such payments are not recommended by the American Society for Reproductive Medicine (ASRM) or the American Medical Association (AMA) on ethical grounds.

Once donating and adopting families have selected one another, the embryos are shipped to the adopting family's clinic, where the adopting family then becomes responsible for storage costs incurred.

This depends on the program you are working with. Each program follows a different process for distributing embryos and payment fees. Some programs will have a "per embryo" charge, and others will have a flat fee for services.
We have heard of families who have been able to receive the tax credit for embryo adoption. We have also heard of families who have applied and haven’t received the tax credit. We would encourage you to talk to your CPA about the possibility and they would likely be able to point you in the right direction of an answer.
It really will depend on your specific policy and the coverage you have. We would encourage you to check with your provider to see if they will cover the Frozen Embryo Transfer (FET). Even if they don't, they may cover the medications, screening, ultrasounds or other expenses incurred leading up to the FET.
We are not familiar with any grants available specifically for embryo adoption, however, we do have a webinar that details different options families have used to help cover the costs of their embryo adoption. Some families have fully funded their adoption through low or no-interest loans, grants, employer adoption benefits, insurance and fundraising.
Usually donating families and recipient /adopting families are matched through a clinic or agency. Sometimes donating families self-direct their donation to a couple they have chosen independent of an agency or clinic. While independently arranging an embryo donation match may appear to be less expensive, the parties will be responsible for arranging for legal services, clinic communications, donor/recipient screening, embryo transportation etc. All of these services must be secured independently and coordinated by either the donor or adopter.
The matching process includes the following steps:
  1. Both donating and adopting parents provide the adoption agency or attorney with information about themselves and indicate the type of adopting/donating family they desire.
  2. Donating parents indicate their preferences regarding the age, income, post-birth work plans, religion, prior marriages, existing children in the family, and race of the adopting families as well as their desire for future contact.
  3. Assuming an adopting family matches these criteria, their introductory letter, biography, and photographs are sent to the donating family for consideration and possible selection.
  4. If donating parents show interest in a suggested match, their profile information (introductory letter, biography and photographs), and medical health history are sent to the adopting family for their consideration and possible selection.
There are additional ways for donating and adopting parents to be matched. Some fertility clinics will facilitate the matching process, or matches sometimes come about through word of mouth or by searching the Internet. When considering these options, keep in mind that an attorney or agency can be beneficial in mediating communication between the parties, to provide the safeguards that a traditional adoption offers, and to offer education and assistance throughout the process.
Open adoption encompasses a wide spectrum of contact. There is usually no requirement that families meet, exchange last names or other identifying information, but at a minimum, each family will select each other through the presentation of an introductory letter, biography, and small selection of photographs that they each have personally prepared. All such adoptions are considered open. Whether a family wants more contact (via e-mail, telephone, photographs, and letters, sent either directly or through an adoption agency, attorney, or other intermediary) or less contact, families with similar levels of desired contact are able to be matched with one another. Open adoption does not mean co-parenting. The adopting couple is the child's parents.
You will receive a medical health history, a family profile including information about the parents of the embryos and possibly pictures. Your doctor will receive the embryology reports, freezing and thawing protocols, and all infectious disease screening results. If the embryos were created with an egg and/ or sperm donor, you will receive as much information as possible on the donor(s).
After the donor and adopter have agreed upon a match they generally will enter the contract phase of the embryo adoption process. In the contract, specifications will be made regarding communications, relinquishment of parental rights and responsibilities and other items desired by both parties. Once the contracts are signed by both parties, shipment of the embryos can be arranged to the adopting family’s clinic of choice.
The legal agreements signed by both the donating and adopting parties mitigate the risk of the donor parents changing their minds regarding their donation. The donating family contractually transfers their ownership and parental rights by signing a relinquishment contract prior to the embryos being shipped to the adopting family's clinic. The contract agreement and relinquishment are legally binding between the two families. Once the embryos have been transferred, the donating parents have neither legal claim to any resulting children nor any responsibility for them. In each of United States the law states that the woman who gives birth to the child is the child’s legal mother and the man to whom she is married is the child’s legal father.

The level of input will be determined by the fertility clinic or adoption agency through which they are being donated. Frequently donations made through a clinic are anonymous donations. Some clinic programs will allow directed donations where the donor may be able to specify some parameters for the recipient couple.

However, a donor will generally experience a greater level of control through an agency. They can choose the family who will receive their embryos and determine the future level of contact they will have with the family should they successfully bear children from the donated embryos.

Usually donating families and recipient/adopting families are matched through a fertility clinic or agency. Sometimes donating families self-direct their donation to a couple they have chosen independent of an agency or clinic. There are a few online matching services where donating and recipient families register with their particular profile stipulations and then independently search the listings to find a potential match. Email messages are exchanged the parties determine if the match is final. The service does not match parties, provide legal services, clinic referrals or donor/recipient screening. All of these services must be secured independently.
No, embryo adoptions do not have to be open, but open adoption encompasses a wide spectrum of contact. There is usually no requirement that families meet, exchange last names or other identifying information, but at a minimum, each family will select each other through the presentation of an introductory letter, biography, and small selection of photographs that they each have personally prepared. All such adoptions are considered open. Whether a family wants more contact (via e-mail, telephone, photographs, and letters, sent either directly or through an adoption agency, attorney, or other intermediary) or less contact, families with similar levels of desired contact are able to be matched with one another.

Several embryo adoption agencies allow you to choose your own physician to perform the frozen embryo transfer (FET). The agency should be able to provide you with a list of clinics in your area that they have worked with successfully.

Some clinics are reluctant to accept embryos that were created in another clinic. Statistics around the creation, freezing, thawing and birth rate using frozen embryos are important to clinics because they use these statistics to draw patients to their facilities. Looking at these statistics is one indicator for choosing a clinic for your own medical treatments.

Other embryo adoption programs require you to use the physician(s) associated with the program.

The frozen embryo transfer (FET) procedure is the same whether the patient uses donated embryos or her own. The procedure is performed in a fertility clinic and can be done during an un-medicated/natural cycle, but medicated cycles are more common as they provide more control in the timing of the transfer. Sometimes, a mock cycle is done to test the effects of the medicine on the body. If this is successful, the cycle is done again and the embryos are transferred. Potential medications used in the cycle include: antibiotics, oral contraceptives, prenatal vitamins/calcium supplements, pituitary suppressors, baby aspirin, estrogen supplements, and progesterone. Understanding the FET process may be an important part of your selection of a fertility clinic.
Hormone preparation for FET

Using hormones to prepare the uterus is the most common way in which a frozen embryo transfer is performed. The first step is to suppress the pituitary gland. This is necessary to reduce the chances of ovulation occurring unexpectedly. Typically Lupron is used for pituitary suppression, and for most women, this will require approximately two weeks of daily Lupron injections.

The second step in a frozen embryo transfer cycle is to use hormones to duplicate the changes that normally occur in the uterus during a regular menstrual cycle. This requires the use of two hormone medications: estrogen and progesterone.

Estrogen preparation for FET

During a normal menstrual cycle, estrogen is produced by the developing follicle. This estrogen acts on the uterus to thicken and mature the uterine lining. Estrogen is given in a FET cycle for the same reason. There are many different ways that estrogen can be given in a frozen embryo transfer cycle:

  • Estrogen pills — Estrace, Premarin
  • Estrogen patches — Estraderm, Climera
  • Estrogen injections — Delestrogen (estradiol valerate), Depogen (estradiol cypionate)
  • Vaginal estrogen — Vagifem, Femring

There is no data that any one method works better than another and a method is usually chosen based on physician preference.

During the time when estrogen is given, the woman will come to the office periodically to be monitored. A transvaginal ultrasound is performed to determine the thickness of the uterine lining and a blood test is performed to look at the level of estrogen in the blood. On occasion, if the lining is not thickening as it should, the dose or type of estrogen must be increased or prolonged. The length of time the estrogen can be given is very flexible. During this phase, for example, the duration of estrogen may be prolonged to delay the day of embryo transfer to accommodate the patient's schedule.

The monitoring in a thaw cycle is very flexible. Unlike a fresh IVF cycle during which the required days for monitoring are determined by the growth of the follicles in the ovary, in an FET cycle, the days can be adjusted at any time. Thus, a frozen embryo transfer cycle is much less stressful on the patient.

Progesterone in an FET cycle

When the uterine lining has been thickened sufficiently, progesterone is added. Once the progesterone is added, the Lupron may be stopped. Progesterone matures the uterine lining and makes it receptive to an embryo to implant. Once the progesterone is begun, there is a certain window of implantation during which the embryo must be transferred. The stage of the embryo must match the stage of development of the uterus. Therefore, the only factor that locks the patient into performing the transfer on a certain day is starting the progesterone. Once the progesterone is begun, if the embryo transfer is not performed on a certain day, the cycle must be cancelled and a new preparation with hormones must be begun after allowing a period to occur.

There are many different types of progesterone that can be used in a frozen embryo transfer cycle. Some of the more common methods include:

  • Progesterone pills — Prometrium
  • Progesterone injections
  • Progesterone vaginal suppositories
  • Progesterone vaginal gels — Crinone, Procheive

There is considerable uncertainty in the medical literature concerning which type of progesterone is the best for FET cycles. Again, the choice of progesterone for an FET cycle is up to the discretion of the physician. However, most experts would agree  progesterone given by mouth is unreliable due to variable absorption and subsequent metabolism in the liver.

Once the uterine lining is adequately thickened with estrogen, the progesterone is usually started on a particular day to allow for scheduling of the embryo thaw and embryo transfer.

One of the benefits of having a Frozen Embryo Transfer (FET) an embryo adoption is that no egg retrieval is required because the embryos are already in existence. Couples participating in FETs can skip right to preparing the woman’s body for pregnancy by building up the lining of her uterus. As a result of having the embryo ready, once her lining is optimal, the embryo (or embryos) can be transferred. This shortens the overall timeline considerably for a couple undergoing a FET as compared to a fresh embryo cycle.
No, it will not be the same. There are fewer drugs needed because the ovaries need no additional stimulation to produce several eggs at ovulation. There will still be estrogen treatment to begin to prep the uterine lining for around two weeks. Following that, the patient will get both estrogen and progesterone to build up the uterine lining for implantation.

If a woman has regular, ovulatory menstrual cycles, a frozen embryo transfer can be performed without the use of hormone preparation. Several studies have shown that the pregnancy rates in natural FET cycles are equivalent to that of hormone prepared cycles. In practice however, these cycles are much more difficult logistically to perform.

In order for the FET to be successful, the embryos must be transferred on the day that the uterine lining is the most receptive. This requires precise determination of the time of ovulation. This can be done through careful monitoring, either as assisted by the clinic using blood tests and ultrasounds or some clinics will allow patients to monitor their cycle at home using ovulation kits.

Unfortunately, during a natural cycle, the day of ovulation is not as controlled. Additionally, if the cycle is considered less than optimal, then the transfer day may be pushed back.

Adopting families should limit the number of embryos transferred to the number that they are willing to carry to term in the event that all the embryos implant. Some embryo adoption programs specifically require their adopting families to agree to transfer all thawed and viable embryos and to not selectively reduce the number of embryos that have begun developing.

Due to the risks associated with of a multiple-baby pregnancy, most doctors recommend limiting the number of embryos transferred to no more than three embryos at a time. This is something adopting families should discuss with their doctor prior to their scheduled embryo transfer. The ASRM also provides members with transfer guidelines based on the woman's age.

A pregnancy using donated embryos does not involve any special or increased factors of risk. It is important to consider the age and any medical conditions of the donating parents and to discuss this and all other pertinent details with the obstetrician.
A few questions you may want to consider asking when preparing for your transfer would include:
  • Ask the clinic about their labeling protocol for embryos. (They should use at least two, and preferably more, unique identifiers such as bar-coding, color-coding, name, number, etc.)
  • Ask the clinic if a nurse is available to work with you individually if needed to make certain you understand how to administer the medication. Not all mistakes in infertility treatment are by the clinic itself. Infertility medications can be confusing to administer.
  • Is the clinic willing to work with your natural cycle for the FET or will they require you to do a medicated cycle? (This will depend somewhat upon your doctor's preferences and may not be an option for every woman, depending upon the regularity of her cycles)
  •  How many embryos does the doctor recommend that you transfer per each FET cycle?
  •  Does the clinic prefer to do mock-transfers prior to the actual FET?

The quality of embryos is determined by a variety of factors. The reality is that healthy children have been born from very 'low quality' embryos and 'very high quality' embryos do not always thaw properly. Just because an embryo has certain quality characteristics associated with them does not guarantee a given outcome.

There have been children born from embryos that have been frozen more than twelve years. There have been healthy children born from embryos that were deemed to have defects 'incompatible' with life. There have been children born from embryos that were frozen and thawed and frozen and thawed again!

What is believed to be flawed by some may become a perfectly healthy baby girl or boy.

It is important to remember that the donor family typically has already been successful in building their family using embryos created at the same time as the embryos they are now placing for adoption. They are donating them because they want to give their remaining embryos a chance at life and they want to help another couple achieve pregnancy and children.

Issues and concerns unique to children born from adopted embryos have yet to be identified and there are no long-term studies available. Similar psychological issues associated with adopting domestically or internationally may arise with embryo adopted children. Working with an experienced adoption agency will help you understand the unique needs of an adopted child and help equip you to meet those needs. Additionally, a reputable agency will be available to you for future counseling as your children mature.

Current ASRM/FDA recommended blood tests include: HIV I & II, HTLV I & II, Hepatitis B surface antigen, Hepatitis B Core Antibody (IgG/IgM), Hepatitis C Antibody, RPR (Syphilis), CMV IgG/IgM, Gonorrhea/Chlamydia culture, Blood Typing, and Rh factor.

The FDA requires that parents who create embryos on or after May 25, 2005 must have their blood screened twice for infectious diseases. The first screen is done at the time of collection/creation and the second screen must be done at least six months later. This is to ensure that no infectious diseases were contracted during the month or two preceding the collection, which would not have shown up on the first screen.

Parents who created embryos before May 25, 2005 are recommended to have this second screening done, but there is no FDA requirement. However, most clinics who agree to accept embryos from other clinics will require a second screening, even if they embryos were created far before May 25, 2005. If an egg or sperm donor was used in the creation of the embryos before May 25, 2005, the original screening results are sufficient. It is not necessary to locate him or her for additional blood testing.

If the embryos were created prior to May 25, 2005, and the donating parents are not able or willing to complete additional blood testing, a waiver can be signed by the adoptive parents stating that they are aware of the lack of testing and choose to accept any risks.

Fees for the screens are covered by the adopting parents, although donating parents may have to pay initially and then be reimbursed.

Some clinics may also require some tests or screens for the recipients. This is contingent on what tests were already performed, the standard practices of the doctor and clinic, and any specific risk factors associated with the patient, such as age. Adopting parents should consult with their doctor to find out what testing needs to be done.

If you are working with a private embryo adoption provider, the agency or attorney should coordinate travel for the embryos between the two clinics. Otherwise, the donor will need to discuss with the fertility clinic what paperwork is required to have the embryos released and transferred to another clinic. The donor should also find out what the clinic uses to transport the embryos; often clinics use glass ampules or plastic straws that hold up to six embryos. They must be held in temperature-controlled containers in order to preserve them in a frozen state. The embryos can then be shipped overnight via air courier.

In some cases, the recipient may be able to travel to the donors' clinic and have the embryos transferred without the shipping expenses. Recipients need to first find out how they can be become patients at the clinic and whether the transfer can be performed there.

The agency or attorney with whom you are working should be able to coordinate the rental of an appropriate shipping container for you.

The average pregnancy success rate using a frozen embryo transfer is about 40%. The set of frozen embryos you adopt will have likely already produced children for the donor family, so they have a proven viability.

A study completed in 2009 by the NEDC shows women who use their own embryos will have, on average, a 32% change of delivering to term, whereas women using adopted frozen embryos will have a 35% chance of delivering to term. [Fertility & Sterility, September 2007,Vol.88, pg S267].

Families using their own gametes (eggs/semen) may be encountering difficulty based on their age(s) or other factors. Women who use donated embryos will not have recently undergone egg retrieval, will not have any residual effects of the drugs used to stimulate the ovaries, and as such their bodies may be more receptive to pregnancy. Additionally, the study found that babies from frozen embryos had higher birth weights than babies born from fresh embryos.

Each adoption program should be able to provide you with statistics regarding their pregnancy success rates.

This is a matter which should be addressed in the legal contracts signed by both parties. The donor may not want to have the embryos returned to them after the adopter has completed their family building. In this case, the adopter determines the disposition of the embryos based on what was legally agreed to in their contract.

Some contracts will specify a period of time in which the embryos must be thawed and transferred by the adopter. If more time is needed, another relinquishment will be requested from the donor.

If the adopting parents have remaining embryos that they will not be transferring at a later time, a best practice is to have the embryos returned to the original donating family. The original family may then determine if the embryos may be adopted by another family. This gives the original donor control over who gives birth to genetic siblings of their children.

The success rate for thawing frozen embryos will vary by clinic - from 50 - 75%. Each clinic reports on its own statistics to the U.S. Center for Disease Control (CDC). It is advisable to discuss these statistics (found at CDC Fertility Clinic Statistics) with any clinic being considered for the frozen embryo transfer (FET) process.

A story about embryo thawing…

One family adopted embryos from two different families. One embryo was adopted from one family, and five embryos were adopted from a second family. The time came to transport the embryos to the adopting family's clinic via Fed Ex. The adopting mother was prepped for her embryo transfer and the physician doing the frozen embryo transfer asked for the five embryos to be sent to the clinic. The one embryo from the first family remained frozen at the original IVF clinic.

The physician felt the statistics were better with five, so he wanted the five for the transfer. Unfortunately, when the five embryos were thawed, none survived. Because the doctor had a patient prepped for transfer with no embryos, he called to have the one embryo sent over. Fed Ex priority overnight delivered the one embryo the next day, and the transfer occurred. Against statistical evidence, two weeks later the pregnancy test was positive! Nine months later a beautiful baby was born from that one embryo. The truth is it only takes one embryo for a successful pregnancy.

In another instance a doctor reprimanded his patient for adopting a set of embryos. The doctor thought the embryos were very poor quality and he could not believe she had adopted these embryos on her own free will. The doctor did not want to proceed with the transfer. The adopting parents proceeded against his advice. Nine months later, the mother gave birth to their son.

The success rate for embryos transferred during an FET is the same to slightly better than those implanted from fresh cycles of IVF, averages 35%. [When achieving pregnancy naturally the average success rate is 25%.]

In some cases, success is more likely because the woman’s uterus and body have not just had surgery for egg retrieval. Also, because the uterus and body will not have to be stimulated for egg production, her body is more receptive to pregnancy and will not have any residual effects of the drugs used to stimulate the ovaries that can be harmful to a pregnancy. In some ways, FETs are more successful. For example, babies from frozen embryos had higher birth weights than babies born from fresh embryos.

Frozen embryos do not have a determined 'shelf-life'. Babies have been born from embryos that have been frozen 15+ years. Babies have been born from embryos that were frozen, then thawed, then frozen and thawed once again. Recently, in the U.S. a baby was born from an embryo which had been frozen for nineteen years. There are quite a number of other instances where embryos which have been stored over 10 or more years have resulted in successful pregnancies.
Multiple births are less common with frozen embryo cycles than with fresh embryo transfers, but this in no way guarantees that an adopting family will not have twins or triplets. Adopting families should consult the Society for Reproductive Technology, ASRM, the Center for Disease Control, and their fertility clinic for statistics regarding multiples birth rates. Careful thought should be given to the number of embryos to be transferred in any given frozen embryo transfer (FET) cycle as transferring multiple embryos does increase the risk of multiples. The Centers for Disease Control (CDC) also maintains data submitted by U.S. clinics regarding the number of embryo transfers, success rates and incidents of multiple births. You may see this data displayed for each unique clinic on the CDC website.
If a match between adopting and placing families does not result in a pregnancy after thawing and/or transferring all of their embryos, another match can usually be facilitated by your agency with another donating family. Your original fee may cover the cost of new match or there may be additional fees assessed. This may include a nominal fee to cover counseling for the new donor couple, new paperwork and embryo transportation. We strongly recommend that you clearly understand what is and is not included in the program you are considering, as each embryo adoption program is different.
Remaining Embryos - What are Our Options?
Can We Place Our Embryos for Adoption?
The Process - How Do We Donate Our Embryos?
Costs
Matching Your Embryos with the Adopting Family
Who is the Adopting Family?
Legal Aspects of Donating Your Embryos
Medical and Emotional Aspects of Donating Embryos

You created your embryos with love, and the hope and dream of a child. You may not have anticipated having remaining embryos and may find yourself feeling overwhelmed with the decision for their future. You have four options for your remaining embryos:

Donate Embryos for Attempted Pregnancy and Childbirth

Embryo donation and adoption is a great way to help another couple with the same hopes and dreams of a child, while giving your embryos an opportunity to be born into a loving family. The donation process can be anonymous or you may choose the family who receives your embryos. Several agencies and clinics have programs to assist you. The EmbryoAdoption.org website contains detailed information, videos and personal stories about embryo donation and adoption.

Release Remaining Embryos to Scientific Research

Frozen embryos are used by scientists for experiments, including embryonic stem cell research. Talk to your physician to understand the qualification process and available programs.

Keep the Remaining Embryos Frozen

Couples who choose to keep their embryos frozen may not be done with their family building or may be facing unexpected personal issues that make it easier to simply keep them frozen. No "shelf-life" has been determined for frozen embryos; children have been born from embryos that have been frozen for more than 12 years. You will pay annual storage fees to your clinic or your clinic may move your embryos off-site for long term storage at a cryobank.

Dispose of the Remaining Embryos

You may choose to discard your remaining embryos. Your clinic can explain their policies and procedures regarding this choice. Some people choose to have remaining embryos thawed and transferred into the mother's womb at a non-fertile time in her menstruation cycle. Some people choose have a type of ceremony to commemorate the embryos as they are thawed.

Anonymous donation programs are generally managed by fertility clinics, which receive donated embryos to be given anonymously to whomever the clinic chooses. Known donation programs give the donating family the option of choosing the receiving family and they can mutually determine the level of future interaction between families. There are websites that assist donating and receiving families to privately match with one another, establishing a context for a known donation.

Adoption programs regard embryo donation as equivalent to a traditional adoption process since the hoped for outcome is the birth of a child. They will offer similar assistance and services as with a domestic adoption. The adoption agency provides the same safeguards that the traditional adoption process offers, allowing you peace of mind knowing the adoptive family has been vetted through the adoption home study. You also have the opportunity to have a relationship with the adopting family. You may be able to exchange pictures and letters, have telephone conversations, or choose to meet the adopting family. The agency may also be available to facilitate communication between the families and to coach you on how to talk to your child(ren) about their unique conception and adoption-related issues.

Typically, placing or donating parents tend to use the term 'donation', while receiving or adopting couples tend to use the term 'adoption'. The basis for this is largely psychological. Donation is used in the sense of 'giving a gift' and offers an emotional separation from the embryos that the phrase 'placing for adoption' does not. Yet for the family wanting to parent the children born from such a gift, the term 'adoption' makes more emotional sense. It is the term that both legally and socially explains the transfer of parental rights associated with traditional adoption. Adoption also helps to describe and explain to their child the way in which they became a family, since children are 'adopted' rather than 'donated'. Frequently the terms are used interchangeably like the words lawyer and attorney.

Embryo adoption provides the same safeguards that the traditional adoption process offers. The placing family knows that the family they have chosen to parent their child has been screened for a criminal history and child abuse record, as well as educated about how to parent an adopted child. The placing parents have the peace of mind of having personally selected a family to raise their genetic child. They also have the opportunity to have contact with the adopting family to whatever extent both families are comfortable. The children, full genetic siblings, would also have the opportunity to connect later on if they desired.

Embryo adoption agencies, unlike the typical donation program, offer families the same safeguards and education available in a traditional adoption. This includes a homestudy, which is conducted for the adopting family and includes criminal screening and adoption education. They allow both the placing and adopting families to participate in the selection of each other. In an anonymous embryo donation, most often a doctor in a clinic decides to whom embryos are given. An agency recognizes the importance of counseling for all parties involved, especially counseling to the adopting family on the best approaches to educating their child regarding his/her adoption.

Embryo adoption is not recognized as an adoption by law, but as an exchange of property. In a standard adoption, the child must be born prior to being adopted. An agency already has in place a set of legal documents that can be customized to fit each embryo adoption situation. These legal documents are well organized and contain all of the special considerations for embryo adoption.

The adoption agency will also help coordinate the transportation of embryos from the donating family's clinic to the adopting family's clinic in the safest possible way.

An adoption agency will provide the families with post-adoption counseling assistance as well as provide a support network with other embryo donating and adopting families. They may also assist in communication between the two families as determined by the families.

Embryo adoption is just one of several family building options. Couples should evaluate the pros and cons of all of the adoption alternatives available to them and make the choice that is right for their family.

If newborns were available at the same rate as embryos, many adopting families would most likely take the child already born, since there is no guarantee of a pregnancy with embryo adoption and donation. However, there are many families for whom the possibility of being able to experience pregnancy is a crucial factor in their decision to pursue embryo adoption over traditional adoption.

It is also important to keep in mind that some families may not necessarily be open to adopting children over a certain age or sibling groups and families ready to open their homes to a foster situation may not desire to give birth to babies.

Many clinics will freeze and store your embryos at their facility for an annual fee. Most families choose this option because they have not completed their family building.

Each year when a couple receives their annual storage fee invoice, they have another opportunity to face this decision. Some clinics will only store embryos for a certain number of years. Some clinics may only store them on-site for one year and then automatically transfer them to a long-term storage facility. Several cryobanks have been established for long-term storage of embryos and other human tissues, often offering storage at much more affordable rates than are available at fertility clinics.

We understand the difficult decision parents are faced with when they realize they have embryos they don't plan to use for their own family building. Should you choose not to donate your embryos, the options are to donate them for scientific research or thaw and discard them, both of which effectively destroy the embryos, or do nothing and keep them in storage until a later time.

If none of those options feel right for you, perhaps you should reconsider the compassionate and caring option of helping another infertile couple build their family. Embryo donation and adoption provides a way for you to select a couple who will receive the embryos. You can be involved as little or as much in the matching process as you would like.

Most experienced embryo adoption agencies will accept all embryo donations regardless of the genetic mother's age, length of time in storage, medical grading or stage of embryo development. All of these factors will be disclosed to the potential adopting family as a part of the matching process, but do not necessarily guarantee if they will be successful with their frozen embryo transfers. Many adoptive families have had children from embryos that have been frozen for over 10 years.
Frozen embryos do not have a "shelf-life". The reproductive tissue is frozen and would be ready for implantation after thawing when the adopting couple is ready for their frozen embryo transfer. Embryos that have been frozen for 10+ years have resulted in healthy pregnancies.
Yes. Because embryo adoption programs typically work with embryos in varying numbers from more than one clinic, it is possible for a donating family with only one embryo, in conjunction with another donating family with more embryos, to be able to offer that embryo to a recipient couple. In the event that embryos from both families are transferred at the same time and a pregnancy results, a DNA test should be performed upon birth of the child to determine the genetic parents of the child.
Yes; in fact, this type of situation is very similar to a domestic adoption where the birth mother doesn't know who the birth father is, and yet the child is still adopted. There are families who are willing to work with a situation where there is limited information available on the embryos being offered.
If the contract you signed with the donor does not specify that the eggs or sperm are for your personal reproductive use only, you can place the embryos with another family. If you are working with an embryo adoption agency, they can likely assist you through the process of obtaining the required documentation to place your embryos. FDA rules and regulations need to be followed. In addition, you will also need to provide any information you have about the donor (i.e. donor profile). Verification of the donor's infectious disease screen results must be obtained from either the donor agency or your clinic.
Yes. Some programs have eligibility requirements for embryos, while others do not; be sure to research all your options. Embryo adoption programs tend to be more open to receiving any number or quality of embryos and work diligently to place all embryos in loving families. Many healthy children have been born from embryos given a poor quality rating.
There have been no definitive studies proving how long embryos can stay frozen and remain viable. Some clinic embryo donation programs may set limits regarding the length of time embryos have been frozen and whether they will accept them; most adoption agency programs however will accept embryos regardless of the amount of time frozen. There are quite a number of other instances where embryos which have been stored 10 or more years have resulted in successful pregnancies.
It’s great that you are thinking about contingency plans for remaining embryos in the event of an unexpected life change such as death or divorce. Making decisions for the embryos' future now is an important step. Some embryo adoption agencies will allow you to complete their application to be then kept on file for future use. We would recommend that you select an agency to work with in that event and determine what steps you will need to take in order for them to assist you in setting up this plan for your embryos. Many times these steps will include updating your will so that the executor can make sure your wishes are fulfilled, notifying your clinic, completing any required clinic release forms, and having infectious disease tests performed.

The first step is to select an agency or clinic program. It's important to research and select a program that meets your needs. We know that there is a lot involved in making this decision and we welcome you to Contact Us with any questions.

When working with a program you will be asked to complete forms regarding yourselves (and if you used donor egg or sperm to create the embryos, you will provide the information you had about the donor). You will also provide information about and your preferences regarding the adopting couple. Yes! You can have control over who receives your embryos. After you are matched with a family, you will complete legal contracts, relinquishing the rights to the embryos to the adopting family. Embryos are not given to the adopting family until these contracts are completed to your satisfaction.

It is in the best interest of the children involved that all of a family's embryos be placed with one adopting family in the hopes that one family will give birth to all the siblings from a group of embryos.

Should the adopting family complete their family building without using all of the adopted embryos, the adopted embryos should be returned to the original donating family. It will be this family's decision whether to place the embryos with a second adopting family.

When a clinic is managing the embryo donation and it is an anonymous, non-directed donation, the clinic will determine how the donated embryos are distributed to recipients. Embryos from one donor may be given to multiple recipients.

Yes, the genetic parents of the embryos are required to have completed the full FDA Reproductive Donor Panel of infectious disease testing. When you created embryos, you likely completed basic infectious disease testing, but there would have been no reason to screen you as a reproductive donor unless you used a surrogate. Now that you’re donating your embryos to another couple, the FDA places you in the same category as an egg or sperm donor. (Note: if you used an egg or sperm donor, then ONLY the other genetic parent will need to complete this. If you used both an egg donor AND a sperm donor, no testing needs to be completed.)

The current FDA mandated panel includes:

    • HIV 1 & 2
    • HTLV I/II
    • Hepatitis B Surface Antigen
    • Hepatitis B Core Antibody (IgG/IgM)
    • Hepatitis C Antibody
    • RPR (Syphillis)
    • CMV IgG/IgM
    • Gonorrhea/Chlamydia Culture
    • Blood Typing
    • Rh Factor

Typically the costs of completing this required testing are covered by the program you are placing your embryos through. Many agencies are able to help you coordinate with an FDA approved facility to complete the required blood draw and urine sample.

If you are working with a private embryo adoption provider, the agency or attorney should coordinate travel for the embryos between the two clinics. Otherwise, the donor will need to discuss with the fertility clinic what paperwork is required to have the embryos released and transferred to another clinic. The donor should also find out what the clinic uses to transport the embryos; often, clinics use glass ampules or plastic straws that hold up to six embryos. They must be held in temperature-controlled containers in order to preserve them in a frozen state. The embryos can then be shipped overnight via air courier.

In some cases, the recipient may be able to travel to the donors' clinic and have the embryos transferred without the shipping expenses. Recipients need to first find out how they can be become patients at the clinic and whether the transfer can be performed there.

The agency or attorney with whom you are working should be able to coordinate the rental of an appropriate shipping container for you.
While this varies a bit between each embryo adoption program, it is common for it to take anywhere between eight and twelve months for your embryos from when you complete your application to the program to be ready to be shipped to the recipient family's clinic. This allows time for you to complete the FDA mandated labwork needed to place your embryos and the agency to find a match, secure the clinic approval, finalize the legal documents and coordinate the embryo travel.

There is no cost to the embryo donor to place their embryos for adoption, other than to maintain the storage until you are matched with the adopting family. The embryo donor does not receive payment for their embryos. This is one of the guidelines established by the ASRM for embryo donation.

For the adopting family embryo donation expenses will range from $12,000 - $15,000 on average. Most of these expenses are to cover the fees with the safeguards of established adoption practices, medical procedures and legal contracts. Embryo adoption is a low-cost adoption alternative when compared to domestic and international adoption, repeated IVF cycles and the cost of donor eggs.

Expenses related to placing your embryos for adoption are usually covered by the recipients. The adopting family is not responsible for any expenses you incurred in the creation and storage of your embryos.
Embryo adoption costs are primarily paid by the adopting family. The donating family should NOT expect to be reimbursed for any of the costs they have incurred for IVF or embryo storage.
Agency Fee* *Additional travel expenses may be incurred for centralized programs. $2,500-$10,000 May or may not include legal fees, embryo shipping, matching services, counseling, additional medical screening
Home Study/Family Evaluation $1,500-$3,500 Costs vary by state
Clinic Frozen Embryo Transfer (FET) $3,500-$6,000 Costs vary by clinic
TOTAL $7,500-$19,500 Generally less expensive than domestic or international adoption
     

Typically, adopting families do not reimburse the donor for any expenses that accrued prior to having been matched with a donating family. Adopting families do often reimburse donating families for any expenses incurred after they are matched. This includes storage and shipping fees, legal costs, and any fees associated with medical or psychological screening.

These may be included in the overall program fee if done through an agency. Any sort of direct compensation for the embryos themselves is under the legal jurisdiction of each state, and interested parties should seek legal advice to determine the applicable laws in their states. In general, such payments are not recommended by the American Society for Reproductive Medicine (ASRM) or the American Medical Association (AMA) on ethical grounds.

Once donating and adopting families have selected one another, the embryos are shipped to the adopting family's clinic, where the adopting family then becomes responsible for storage costs incurred. Depending on how many embryos a donating family has, if an adopting family completes their family with embryos still remaining, there may be a chance that those remaining embryos would once again become the donating family's responsibility for storage fees and selection of another family.

An anonymous donation occurs when donor and recipient identities remain unknown. No contact is made between the donor and the recipient, either now or in the future. Anonymous donation most often takes place through an IVF clinic, but may also take place through an adoption agency. Most clinics that have an embryo donation program provide very limited information to the recipients about the donors. Donors are rarely involved in the process of selecting recipients, but are sometimes permitted to set stipulations for eligibility to receive their donation. Of course regardless of desired levels of involvement, medical information about the donated embryos is always provided to the recipient when possible.

When you are working with an embryo adoption agency to place your embryos, you can control how much information you receive about the adopting family. Some genetic parents like prefer to simply know that the adoptive family has been vetted through the home study process and allow the adoption agency to select the adoptive family on their behalf. Other families perfer to choose the adopting family themselves. If you want to be a part of the selection process, you will receive a profile from the adopting family which typically shares their fertility journey, details about what their family life is like, and photos.

Each agency follows its own process for matching donors to adopters, but generally you have an opportunity to set parameters around the characteristics you hope to find in the adopting family: age, length of marriage, income, other children, schooling, etc.

When you donate embryos through an anonymous fertility clinic donation program you will not receive information about the recipient family.

The matching process includes the following steps:
    1. Both donating and adopting parents provide the adoption agency or attorney with information about themselves and indicate the type of adopting/donating family they desire.
    2.  Donating parents indicate their preferences regarding the age, income, post-birth work plans, religion, prior marriages, existing children in the family, and race of the adopting families as well as their desire for future contact.
    3. Assuming an adopting family matches these criteria, their introductory letter, biography, and photographs are sent to the donating parents for consideration and possible selection.
    4. If the adopting family is selected, then the donating parents' profile information (introductory letter, biography and photographs), and medical health history are sent to the adopting family for their consideration and possible selection. There are additional ways for donating and adopting parents to be matched without an attorney or agency. Some IVF clinics will facilitate the matching process, or matches sometimes come about through word of mouth or by searching the Internet. These Internet profiles allow an interested party to find a profile that fits their criteria and make contact through email. When considering these options, keep in mind that an attorney or agency can be beneficial in mediating communication between the parties, to provide the safeguards that a traditional adoption offers, and to offer education and assistance throughout the process.

Usually the first step after a match is made is to complete the legal exchange of property between the donor and the recipient. Remember it is an exchange of property. Most embryo adoption agencies and fertility clinics will already have contracts in place which they have been successfully using. If you self-match you will need to secure the services of an attorney, preferably one who has experience in assisted reproduction technology law.

After the contracts are signed by both parties, the next step is to get the embryos shipped to the clinic the adopting family has determined to use for their FET. Sometimes, the embryos are already located at this clinic.

No shipping of embryos or FET treatments should be scheduled until the legal agreements are finalized.

Agency adoption programs will allow you to know if a pregnancy occurred and even receive information about the child after birth if you desire.

If you place your embryos anonymously through a clinic donation program it is unlikely you will be informed about any pregnancies from your embryo donation.

The adopting family has a chance to have a relationship with their child's placing family. Whether they share pictures and letters, have telephone conversations or choose to meet the placing parents, the adopting family will know that they have access to information about their child's history, as well as a possible match for any future medical need, such as an organ donation or blood or bone marrow transplants. The agency is available to facilitate communication between the families. The agency will educate and work with the adoptive family about how to talk to their child(ren) about their unique conception and adoption-related issues.
The most obvious difference between an embryo adoption and a traditional adoption is the pregnancy experience. Adoptive mothers are able to experience all the challenges and joys, of pregnancy and labor. They also have the peace of mind of knowing their children received the appropriate prenatal care and were not exposed to alcohol or drugs during pregnancy. There are, of course, certain considerations involved in embryo adoption that are not present in traditional adoption. For instance, because more than one embryo is implanted during the transfer procedure, an adoptive couple might have twins or triplets.
In most donation programs the adopting couple is screened for infectious diseases and for general reproductive health. Some clinic programs will require psychological evaluations (their ability to parent). Adoption agencies will provide the most thorough evaluation of the adopting family, including a criminal background check. They will also provide the adopting family with training in how to be a successful as an adopting parent. The agency is also available to provide the adopting family with assistance in the future as the child matures.

This is a common question asked by embryo, sperm and egg donors. The risk is negligible according to published guidelines and basic statistics. If one couple donates cryopreserved embryos, the chance of accidentally meeting and mating with a sibling is extremely unlikely.

Anonymously donating your embryos to someone in a different state will further minimize the risk. Donating your embryos in an open embryo adoption is the best alternative to virtually eliminate this risk.

Is it more important to match according to physical attributes or to other characteristics?

Families who are receiving embryos typically want children that will look like their family (with similar heredity).

The donating families are concerned with physical appearance but are more interested in other characteristics that usually are similar to their own such as education, financial stability, spirituality, if the mother will work or stay at home, the number of other children in the family, length of marriage, or age of the prospective parents.

You will need to contact your fertility clinic and have them send you and your donation/ adoption organization the embryology reports and freezing and thawing protocols for the embryos, as well as infectious disease screens for the donating parents (or the egg/ sperm donor). If the embryos were created through gamete donation, you will need to submit a copy of the contract you had with your donor, and the information given to you when you selected your donor. The agency/clinic may also request several generations of medical history.
General Information on Embryo Adoption
Processes Associated with Embryo Adoption
Embryo Adoption Home Studies
Starting an Embryo Adoption Program
Legal Matters

Embryo adoption was first introduced in 1997 by Nightlight Christian Adoptions when they established the Snowflakes Embryo Adoption Program. Since that time several more organizations have chosen to establish embryo adoption programs.

Your clients view your agency as a trusted source of information regarding their adoption options. Embryo adoption may be the right adoption choice for your client. Embryo adoption may help to fulfill many of the lingering dreams of pregnancy and giving birth which your clients may have experienced during a difficult infertility journey.

It’s easy to educate yourself, your staff, and your clients about embryo adoption. There are many tools available on this website: videoswebinarsPower Point presentationsmarketing collateral and a comprehensive set of FAQs.

The opportunity to learn is free, and as a professional you will have the satisfaction of knowing that your agency is providing clients with information regarding all options available to them.

If your client chooses embryo adoption, there are several programs they can work with and your agency can still complete the clients' adoption home study.

Currently the Awareness Center has a list of eight active embryo adoption agencies around the country.

The Center has been working with agencies and clinics around the United States over the past several years, encouraging the establishment of new programs. Since that time two new programs have formed and many more are in the process of being established.

There are no national statistics regarding the number of embryo donations/adoptions that occur each year. Each program can vary widely with some programs performing as few as 1 adoption or donation per year, while others may complete as many as 100 placements a year.

There are over 600,000 embryos in frozen storage. The majority of those are being held for future use by the folks who created them. However, a significant number of them are also being donated each year to other couples. The work of the Awareness Center is to educate both potential donors and potential adopters about the success of embryo donation and adoption and the great satisfaction and joy it can bring to both families.

We suggest that you begin to educate your potential clients about embryo adoption as an adoption option in your informational meetings or in your one-on-one meetings with clients as you are educating them about domestic, international or foster adoption.

The Embryo Adoption Awareness Center has created videoswebinarsmarketing brochures and Power Point presentations to help you in this education process.

There is some support for the application of the adoption tax credit to embryo adoption. Some families have applied for the tax credit with regard to the fees paid to their agency for the adoptive home assessment, educational component, and other adoption agency or attorney expenses directly relating to the adoption of the embryos. These may be families who have participated in an embryo adoption program and who have given birth to a child as a result.

We would advise you to conduct your own independent research as to the applicability of the adoption tax credit to embryo adoption or to seek the advice of a tax professional, Certified Public Accountant, or financial adviser.

The easiest way agencies can participate is through self-education followed by client education. Potential clients see your agency as a trusted source of information regarding all things adoption. Adding embryo adoption to your list of adoption options simply increases your value as a reliable information provider.

If you have a client who chooses to pursue an embryo adoption through another agency, your agency may perform the home study for the family. By providing embryo adoption home studies to clients, you are preparing, training and educating families for their life ahead as a parent of a child who has joined their family in very unique, but special circumstances. A list of existing embryo adoption agencies is available to help you explore options for partnerships.

Embryo adoption costs are primarily paid by the adopting family. Generally the donating family does not receive payment for their donation nor should they expect the recipient family to cover any of the IVF expenses they had previously incurred. Embryo storage costs prior to the match are also the responsibility of the donor family. The recipient family may be asked to pay for storage fees after the match is made.

Agency Fee* *Additional travel expenses may be incurred for centralized programs. $2,500-$10,000 May or may not include legal fees, embryo shipping, matching services, counseling, additional medical screening
Home Study/Family Evaluation $1,500-$3,500 Costs vary by state
Clinic Frozen Embryo Transfer (FET) $3,500-$6,000 Costs vary by clinic
TOTAL $7,500-$19,500 Generally less expensive than domestic or international adoption
     
After clients have submitted their application to an embryo adoption agency they will need to complete a home study (unless they have completed one within the previous 12 months). After the home study is completed it will be an average of six to twelve months until the embryos are ready to be received by the adopting family. After the adopting family completes the required application documents, the agency will begin the process of matching the adoptive family with a donor family. The length of time will vary based on many factors including: the client’s age, the requirements they specify on their application for a donor family and the quality of the embryos the family requires. After the families are matched the genetic family will relinquish the parental and legal rights to the embryos to the adopting family through contractual agreements. Then, the agency facilitating the adoption can coordinate the travel of the embryos to the adoptive family's clinic or they may travel to the embryos for the frozen embryo transfer. If one of the transferred embryos implants in the womb and a healthy pregnancy is established, a baby will be born nine months later!

An adoptive home study for the recipient couple ensures that the safeguards currently in place for traditional adoption also protect the child, the placing parents and the receiving parents in an embryo adoption situation.

Despite the fact that the adoptive mother gives physical birth to a child from an embryo donation, that child is still an adopted child; he or she shares no genetic relation to the adoptive mother or father. When children are born into a family to whom they are not genetically related, they will have the same types of questions as those of children adopted through traditional means. The home study process provides the adoptive family with an opportunity to learn about and anticipate these types of issues and questions. The home study also educates the parents in the best way to address and answer these questions with sensitivity to the needs of the child.

Since the home study process provides the donating parents with assurance about their embryos' prospective parents, they also benefit. This assurance includes:

    • the adopting family has been evaluated for any health issues that may affect their ability to care for and raise a child,
    • has been screened for any criminal and child abuse issues,
    • has been educated concerning the potential issues of parenting a non-genetically related child
There are emotional impacts on both the individual and the couple, not to mention the personal, financial, sexual, and spiritual concerns that adopters commonly feel with the process of Embryo Adoption. Keeping in mind that the hoped-for end result of the adoption is the birth of a child, it is incredibly important to help your client come to conclusions about how they will share with their child about their origins. Providing in-depth counseling helping them overcome the psychological impacts of infertility is a good first step.
The point at which an embryo adoption is considered finalized may vary. Some programs will consider the adoption finalized at the time that the contracts transferring the rights of ownership are completed. Other programs will consider the adoption finalized at the point of thawing and transfer of the embryos into the adoptive mother's womb.

Just like in a traditional adoption, there are several advantages to encouraging open adoptions between donor and adoptive families. Among them is the ready exchange of information, including information on medical conditions.

Open adoptions can also ease the process of explaining a child’s genetic history to them. Adult adoptees and adults conceived from donor insemination have explained why honesty is important for an understanding of who they are, where they came from and for knowledge of their own medical history. Children given life through embryo adoption have the same right-to-know as any other adoptee so they can understand biological roots and have a medical history. For these reasons and many other sociological and psychological reasons, we strongly suggest encouraging open embryo adoptions.

The Embryo Adoption Awareness Center offers a webinar to help agencies understand how to modify their existing domestic adoption home study process to support embryo adoption. This webinar, Conducting a Home Study for Embryo Adoption, is available in the Webinar Archive section of this website.
Embryo Adoption home studies are similar to traditional domestic home studies with some modifications. The main purpose of an embryo adoption home study, following in the steps of a domestic home study, is to provide education and training for adopting families. Potential topics to address during the home study process include:
    • Understanding of infertility issues
    • Understanding of donor egg and/or sperm and how the Donor Sibling Registry can help the child be connected to other genetically related individuals
    • Exploration of reasons for choosing embryo adoption
    • Discussion of grief and loss issues through exploring the couples infertility journey
    • Discussion of the loss of a mutually genetic child
    • Discussion of the joys (and challenges!) of being able to experience pregnancy and gestational bonding
    • Addressing the couples' control of prenatal environment
    • Specifying preferences regarding donor
    • Discussion of the potential for genetic siblings and how the adopting couple will address this unique dynamic with their adopted child
    • Addressing the couples feelings about giving birth to an adopted child
    • Discussion of how the couple may have remaining embryos for future family building
    • Addressing the fact that no finalization process is required by law but is recommended as best practice
    • Covering the potential for a multiple birth pregnancy
    • Preparing the clients for the possibility that donated embryos may not survive thawing, the embryo transfer may not result in pregnancy or that a pregnancy may not be carried to term
    • Addressing the fact that a couple may complete family building and have remaining embryos
    • Guiding adopting couple in determining their preferences for donor/embryos based on genetics and family background
    • Working through the family profile creation with the client and assisting them in presenting themselves with integrity, remembering that the donor family has also experienced infertility
    • Exploration of contact with the donor family, including reasons for establishing and maintaining contact, exploring resistance, level and type of contact and building positive relationships with the donor family
    • Addressing the couples' plans for sharing about the adoption with the adopted child and their extended family

A typical time investment can range from 100 to 200 hours per family choosing to adopt or place embryos in adoption or donation program. The time spent can be broken down into the following types of activities:

    • processing the application
    • counseling and matching the families
    • preparing the documents for transfer of legal ownership
    • coordinating the medical documentations
    • facilitating shipment of the embryo

This list is by no means exhaustive and the time required to place embryos may vary greatly depending on the needs and desires of each individual family.

As an agency you may choose to provide your client with a home study and then work with an established embryo adoption provider for program services to your client.

Should your agency have an interest in starting a new program, here are some items to consider:
  1. Do you have current personnel to manage a new program or will you need to add staff?
  2. Are you interested in working with an experienced provider first, perhaps providing the home study for the adoption initially, and learning more through your participation with the experienced provider?
  3. Are you interested in or willing to hire an expert who can provide insight and guidance in the establishment of a program?
  4. What geography would you like to cover?
  5. What types of marketing will be required to build an in-house program?
  6. Where/how will you acquire donated embryos?
  7. Can you find and partner with a local attorney who either has experience or is willing to learn about the legal aspects in your state(s)?
As in any adoption program, the fees charged will vary depending on the organization offering the service, the geographical area being serviced, and the motivations of the program founders. Typically, the fees for embryo adoption are less than those for a traditional adoption.

When an agency chooses to partner with a fertility clinic the benefits positively impact both the adoption agency’s clients and the agency’s business.

For clients, a partnership with a fertility clinic means an established potential source of donor embryos. Fertility clinics appreciate controlling the creating, freezing, thawing and transfer of embryos within that clinic. They feel that it gives their patients (your clients) a better opportunity for pregnancy success. For an agency, this means that a clinic partnership may provide a new source of revenue by opening opportunities for donor and adopter counseling, home studies and program fees.

In an agency-clinic partnership, each entity provides their expert services. The clinic focuses on the medical aspects of embryo adoption, while the agency provides the social, psychological and legal aspects of the adoption process. This eliminates future adoption-oriented liabilities to the clinic. They are not liabilities to the adoption agency, because the tasks are already a part of the adoption process.

The greatest way any agency can participate in embryo adoption is simply to let clients know it is a viable alternative. We believe that an agency who includes information about embryo adoption in the education of their clients presents themselves truly as the expert in adoption alternatives to their client.

Embryo adoption is certainly not the right choice for everyone, but NOT knowing the choice is available can be detrimental as well. Many folks who have now successfully added embryo adopted children to their family, previously added children through domestic or international adoption. They learned about embryo adoption in their pursuit of additional children to build their family.

The reason the Awareness Center works diligently to educate adoption agencies and clinics is because they are the gateways to the potential adopter and donor of embryos. It is our hope that both agencies and clinics will join us in raising awareness regarding embryo donation and adoption.

General Information on Embryo Donation/Adoption
Medical Information and Requirements
Storage and Transportation of Embryos
Guidelines for Embryo Recipients

The focus of fertility clinic embryo donation programs is helping their patients achieve pregnancy. The medical staff of the clinic will normally choose which patients will receive particular donated embryos. It is not uncommon to have embryos donated by one family, and therefore genetically the same, divided between multiple recipients. The donor most likely will not know or be known by the recipient(s). Psychological evaluations for the donor or recipient are generally encouraged or required. Donation programs within the clinic environment are mostly limited to the current patient population. There are a handful of clinics who make their embryo donation programs open to all.

Adoption programs regard embryo donation as equivalent to a traditional adoption process since the hoped for outcome is the birth of a child, a child who is not related genetically to the recipient family. They will offer similar assistance and services as with a domestic adoption. The social and emotional aspects of this unique family building option are the agency's focus. Education of the donor and adopting family is child-centric with the end goal to help both families and the resulting children understand and manage these non-medical aspects of the process. Matches are typically mutually agreed upon by the recipient and donating families. Recipient families will typically receive all the embryos that the donor family has remaining. Adoption programs within the agency environment are typically open to all provided that agency eligibility requirements are met.

When a clinic chooses to partner with an adoption agency the benefits positively impact both the clinic's patients and the clinic business. This partnership can move future liability regarding embryo placement issues from the clinic to the agency. The agency maintains the social, emotional and legal education and documentation of embryo adoption.

The beneficial relationship and responsibilities of clinics and agencies can be broken down in the following ways:

  • Embryo adoption agencies frequently have donated embryos waiting for recipient families and your clinic may have a list of patients waiting for embryos
  • Patients may be able to receive donated embryos more quickly through an embryo adoption agency
  • The clinic offers direct assistance from the agency to patients for embryo disposition decisions
  • Agency manages the program, not the clinic, unbiased matching completed by agency
  • Future communication between parties is the agency responsibility not the clinic
  • Reduces clinic paperwork and future liabilities
  • Clinic controls embryo/birth statistics by keeping embryos in-house
  • New patients are directed to the clinic, bringing new revenue
  • Uses embryos created, frozen and thawed by the clinic
  • Reduces embryo storage at the clinic
  • Reduced/eliminated transportation of embryos between clinics

It relieves the couple of the psychological burden of having frozen embryos in storage.

They control the choice of the recipient of their embryo donation.

They are honoring their own children who were born through the IVF process by allowing embryo siblings a chance at life.

They experience the satisfaction of providing another infertile couple the chance to build their family.

There is greater assurance that the adopting family has been well screened and evaluated for their ability to become successful in raising adopted children.

There are no fees for the donating parents to participate in the program. There may be costs during the process if any additional blood work is required per FDA guidelines, depending on where the embryos are going and what types of tests the donating family has had, but the adopting family most likely will be asked to cover these costs.

Typically, adopting families do not pick up any of the expenses associated with the donor family's fertility treatment. Adopting families do often reimburse donating families for any expenses incurred during or after they are matched. This includes shipping fees, legal costs and any fees associated with medical or psychological screening. These may be included in the overall program fee if done through an experienced agency. Any sort of direct compensation for the embryos themselves is under the legal jurisdiction of each state, and interested parties should seeks legal advice to determine the applicable laws in their states. In general, such payments are not recommended by the American Society of Reproductive Medicine (ASRM) or the American Medical Association (AMA) on ethical grounds.

Once donating and adopting families have selected one another, the embryos are shipped to the adopting family's clinic, where the adopting family then becomes responsible for storage costs incurred. Depending on how many embryos a donating family has, if an adopting family completes their family with embryos still remaining, donating family may be able to select a subsequent recipient family for their embryos. In many cases, the first adoptive family continues to cover the costs of storage while the donating family seeks a new match for their embryos.

Your clinic will receive:
    • Infectious disease screening results (an FDA requirement)
    • embryology reports
    • embryo freezing and thawing protocols
It is likely that the program your patients are working with will be able to contact the donating parents and their clinic to obtain additional information as necessary.

The U.S. Food and Drug Administration (FDA) has published regulations regarding human tissue donation that effects embryo donation and adoption. On May 25, 2004, the FDA published final rules addressing donor testing/ screening and good tissue practice. The FDA subsequently issued an interim final rule on May 25, 2005, which amended certain sections of those regulations. For additional information on the rule, see the FDA's website Question and Answer section at:

http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/TissueSafety/ucm095440.htm

Previously, the FDA rules exempted sexually intimate partners engaged in reproductive treatment, from infectious disease testing prior to the creation of their embryos, which were intended for the couple's own use. The interim final rule expanded this exemption, which now permits couples who were not originally screened for infectious disease to donate their cryopreserved embryos to other couples. The regulations do suggest that attempts to test these donor couples should be made before the embryos are transferred to the recipient, but, when testing is not possible, the recipient should at least be advised of the potential communicable disease risk. Given that FDA regulations may change, you should be sure to understand what screening and testing requirements are in effect at the time of the donation.

When issuing the interim final rule, the FDA stated, "We are now adding a new exemption from screening and testing in Sec. 1271.90(a)(4) for cryopreserved embryos that, while originally exempt from the donor eligibility requirement because the donors were sexually intimate partners, are later intended for directed or anonymous donation. When possible, appropriate measures should be taken to screen and test the semen and acolyte donors before transfer of the embryo to a recipient. This change reflects the fact that sexually intimate partners may decide to donate their cryopreserved embryos long after their fertility treatments are completed. Because the embryos were intended for use in a sexually intimate relationship the donors would not have been required to be screened and tested for communicable disease agents at the time that oocytes and semen were recovered. The new provision recommends that appropriate measures be taken to screen and test the semen and oocyte donors before transfer of the embryo to the recipient, when possible.”

The current FDA mandated blood tests include:

    • HIV 1 and 2
    • HTLV I/II
    • Hepatitis B surface antigen
    • Hepatitis B Core Antibody (IgG/IgM)
    •  Hepatitis C Antibody
    •  RPR (Syphilis)
    •  CMV IgG/IgM
    •  Gonorrhea/Chlamydia culture
    •  Blood Typing
    •  Rh factor

Counseling is an important component of the services that should be offered in an embryo adoption and, in fact, is specifically included in the American Society for Reproductive Medicine's (ASRM's) guidelines for donating embryos.

The type of counseling services made available and offered in an embryo adoption situation should be similar to the counseling services offered for traditional adoptions. For example, local area donating families should be provided with counseling services at no charge. Counseling for local adopting families should be included in their program fees. Referrals should be made for families outside of the geographical area serviced by the agencyclinic, or attorney.

There are many areas to potentially cover with the recipient family while counseling them in preparation to receive embryos. Most of these areas are covered with a family who completes a home study in order to pursue receiving embryos through an adoption agency program. If a family is receiving embryos through an anonymous program, some of these topics may not apply. Potential topics to address with recipients include:

    • Exploration of reasons for choosing embryo adoption
    • Discussion of grief and loss issues through exploring the couples infertility journey
    • Discussion of the loss of a mutually genetic child
    • Discussion of the joys (and challenges!) of being able to experience pregnancy and gestational bonding
    • Addressing the couples' control of prenatal environment
    • Specifying preferences regarding donor
    • Understanding of donor egg and/or sperm and how the Donor Sibling Registry can help the child be connected to other genetically related individuals
    • Discussion of the potential for genetic siblings and how the adopting couple will address this unique dynamic with their child
    • Addressing the couples feelings about giving birth to a child who is not genetically related to them
    • Discussion of how the couple may have remaining embryos for future family building
    • Addressing the fact that no finalization process is required by law but is recommended as best practice
    • Covering the potential for a multiple birth pregnancy
    • Preparing the clients for the possibility that donated embryos may not survive thawing, the embryo transfer may not result in pregnancy or that a pregnancy may not be carried to term
    • Addressing the fact that a couple may complete family building and have remaining embryos
    • Guiding adopting couple in determining their preferences for donor/embryos based on genetics and family background
    • Working through the family profile creation with the client and assisting them in presenting themselves with integrity, remembering that the donor family has also experienced infertility
    • Exploration of contact with the donor family, including reasons for establishing and maintaining contact, exploring resistance, level and type of contact and building positive relationships with the donor family
    • Addressing the couples' plans for sharing about the adoption with the adopted child and their extended family

Choosing to donate remaining embryos to another couple is a big decision which can bring up many emotions and concerns for the donating family. Potential topics to address with embryo donors include:

    • Exploration of reasons for choosing to donate their embryo(s)
    • Discussion of grief and loss issues through exploring the couples infertility journey
    • Addressing the couples' feelings about the recipient couple giving birth to and raising children who are fully genetically related to their child(ren)
    • Specifying preferences regarding the recipient
    • Discussion of the potential for genetic siblings and how the donating couple will address this unique dynamic with their child(ren)
    • Discussion of how the donating couple may share with their child(ren) how they came into the family through IVF
    • Discussion of how to help their children understand their unique conception using donor egg and/or sperm and how the Donor Sibling Registry can help the child be connected to other genetically related individuals
    • Discussion of how the recipient couple may have remaining embryos for future family building or may complete their family and still have embryos remaining
    • Preparing the clients for the possibility that donated embryos may not survive thawing, the embryo transfer may not result in pregnancy or that a pregnancy may not be carried to term
    • Working through the family profile creation with the client and assisting them in presenting themselves with integrity, remembering that the recipient family has also experienced infertility
    • Exploration of contact with the recipient family, including reasons for establishing and maintaining contact, exploring resistance, level and type of contact and building positive relationships with the recipient family
    • Addressing the couples' plans for sharing about the donation with their extended family
The embryos remain stored at the original IVF clinic or at a long term storage facility designated by the genetic/donor family during the adoption process. The genetic family pays for storage during this time. Some embryo adoption programs will have storage programs to help offset the costs of storage while the genetic family is awaiting their match.
It is usually the responsibility of the patient's private embryo adoption agency or attorney to coordinate the embryos’ travel between the placing and adopting clinics.
The embryo adoption agency or attorney with whom your patients are working should be able to coordinate the rental of an appropriate shipping container for you.
Your clinic may have time limits regarding storage of embryos at your facility. After that time limit has expired you may require patients to move their embryos to an off-site facility (a cryo-bank) or give them the option to have the embryos discarded. If your clinic already stores embryos at a cryobank or is considering moving them to a cryobank, it is critical for you to understand the rules governing the storage of these embryos from your patient's perspective. How easy will it be for your patient to access their embryos from the cryobank? Will it be a financial burden to them to remove them from the cryobank should they choose to donate their embryos in the future? Be sure to read the fine print and understand the requirements and costs of storage and removal from storage at any cryobank facility.
Time limits are usually incorporated into the legal contract language for the transfer of embryos from one party to another and will often vary by program.

In an embryo adoption program, it is customary for the adopting family to return any embryos they do not plan to use for their own family building to the original donating family. The original family can they determine and choose a second adopting family for their embryos.

This issue is usually detailed in the contracts signed by both parties to eliminate future surprises.