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Approximately 400,000 embryos opposed to sperm or , are frozen (cryopreserved) in the United eliminates the imbalance when only one States. The majority are intended for use by member of a couple loses the genetic the couples who created them in IVF treat - connection to their children. ment cycles, though thousands are poten - • Embryo donation is less expensive than tially available for embryo donation to other egg donation. infertile patients. In keeping with our educa - tional mission, RESOLVE: The National Infer - HOW DO WE FIND A DONOR? tility Association wants to ensure that women There are two types of embryo donation to and men facing are fully informed consider, anonymous donation and known about all aspects of embryo donation as a donation. In an anonymous donation, the family building option. donor’s IVF clinic finds a match with a recipi - ent couple and the donor couple may have SHOULD WE CONSIDER a limited say in the selection process. Efforts USING DONATED EMBRYOS? are made to match physical characteristics, Couples who are deciding whether to use including height, weight, eye and hair color donated embryos must come to terms with and ethnicity. the disappointment and emotional distress of not having their own biological child. This is In a known embryo donation, an embryo- a process and it happens over time. Medical matching agency or program may facilitate factors that might motivate a couple to con - the donation. The donor couple may choose sider embryo donation are: to know detailed information about the • Repeated treatment failures due to unex - recipient couple, the date of the embryo plained factors, or severe male or female transfer and whether a pregnancy resulted, factor infertility; and may request periodic updates about • Multiple pregnancy losses due to issues the child. other than implantation factors; • Transmissible genetic diseases; WHAT SHOULD WE TAKE INTO • Rarely, a woman may have absent or non- CONSIDERATION BEFORE DECIDING functional ovaries or a man may have ab - TO USE DONATED EMBRYOS? sent or nonfunctional testicles, while the You must be willing to: woman has a functional uterus. • Undergo required medical screening These couples may desire to experience and testing; pregnancy, while others find embryo dona - • Participate in a medical consultation and tion preferable to . sign consent for medical treatment; Other couples consider using donated em - • Pay for any of the donor couple’s required bryos because: blood tests; • They believe that using donor embryo, as WHAT RECIPIENT COUPLES SHOULD KNOW

• Meet with a mental health professional to abuse/addictions, marital stability, and discuss using donated embryos, which the ability to cope with the stresses associ - would include discussions about rearing ated with embryo donation. non-genetic children, and whether to dis - close the donation to the child, family WHAT IS THE MEDICAL and friends; EVALUATION AND PROCEDURE? • Seek legal consultation, which may be In addition to blood type and Rh factor, blood required and should include a review of tests will be done to check for immunity to applicable state laws and all consent German measles, chickenpox, and other stan - forms, and may result in the establishment dard prenatal tests. Some clinics will evaluate of a legal contract clearly defining donors’ the uterine cavity to ensure that there are no and recipients’ rights and obligations with uterine problems that would affect implanta - respect to any future children; tion. Medications will be administered for sev - • Assume full responsibility for all donated eral weeks to prepare your uterus for the embryos as well as any resulting children; transfer of the thawed embryos. • Release the donors and the medical clinic or program from liability for any preg - The can be performed nancy com-plications that may arise; either at a clinic near where the embryos • Accept that a child born through embryo were stored or at a clinic where you live. donation may have a genetic sibling It is optimal to perform the embryo transfer being raised in another family. where the embryos are stored rather than move the embryos. There are very few, if WHAT DOES THE PSYCHOLOGICAL any, complications related to the embryo EVALUATION ENTAIL? transfer process. The thawed embryos are The importance of emotional and psychoso - transferred via a small catheter that is in - cial preparation cannot be overstated. Cou - serted through the vagina and cervix into ples considering embryo donation should the uterus. You and your doctor will decide meet once or more with a trained mental how many embryos to transfer as the risk health professional. You must have time to of a multiple pregnancy can be significant. grieve the losses in not having your own genetic child, and explore feelings and WHAT ARE MY CHANCES fears about parenting a child created by OF PREGNANCY USING another couple, or possibly not achieving A DONATED EMBRYO? pregnancy. Issues of disclosure and future Success rates may vary with the donating donor contact with the child must also be woman’s age at the time she created the addressed. The mental health professional embryos. If the woman was over 35, suc - will want information about significant cess rates using those frozen embryos may psychiatric illnesses, current substance be lower. Other factors include the length WHAT RECIPIENT COUPLES SHOULD KNOW

of time that the embryos were stored, the cell RESOLVE wishes to thank the stage, and the quality of the embryos. Live Embryo Donation Advisory Group: birth rates per frozen embryo transfer are Mary Abusief, MD currently 27.7%. Susan Crockin, JD Nanette Elster, JD, MPH LEGALLY, WHAT SHOULD Sheryl Kingsberg, PhD I BE AWARE OF? Jan Elman Stout, PsyD Embryo donation raises new legal questions Lawrence Werlin, MD and considerations for all parties involved in - cluding the clinic or program facilitating the This brochure was supported with funding donation. The parties should seek separate, from the U.S. Department of Health and independent legal representation to draft an Human Services under grants agreement addressing the issues surrounding EAAPA071007-01-00 and EAAPA071007- embryo donation, such as the donors’ relin - 02-00. Its contents are solely the responsi - quishment of rights, the parties’ respective bility of the authors and do not necessarily rights and obligations towards one another represent the off icial views of the De part - and the child and issues involving future con - ment of Health and Human Services. tact and terms of reimbursement. Prevailing state laws as well as the specific needs and Resources : circumstances of each party should dictate the • American Society for Reproductive precise terms of contractual provisions. The Medicine (ASRM), www.asrm.org donor and recipient contracts should contain • Society for Assisted Reproductive the same information. Technology (SART), www.sart.org

WHAT ARE THE COSTS? © RESOLVE—All Rights Reserved The recipient will reimburse the donor for fees associated with the embryo donation, which RESOLVE: The National Infertility may include specific testing and screening ex - Association is the voice for women penses (e.g., obligatory blood tests) as well and men facing infertility. as expenses incurred in storing the embryo or transfer to the clinic. Prior to the donation, all The mission of RESOLVE is to provide timely, details regarding donor reimbursement should compassionate support and information to be agreed upon in writing and may be de - people who are experiencing infertility and tailed in any contractual agreement entered to increase awareness of infertility issues into between the parties. The overall cost to through public education and advocacy. the recipient couple for an entire cycle can range from $2,500 – $4,000, and might not For more information include counseling or legal fees. visit resolve.org/embryodonation