Researchers: Hadar Amir¹, Aviad Raz²

Background: The disposition decision is a frequently unresolved issue for many IVF patients with surplus frozen embryos (SFEs).

Objectives: To explore the choices, attitudes, and (mis)understandings underlying IVF patients’ decisions concerning their SFEs.

Method: statistical analyses were conducted on a group of IVF patients (n=674) whose records were collected in an IVF unit. In-depth, semi-structured interviews were conducted with 21 patients who decided to defrost, 21 who decided to pay for additional storage, 21 who donated to research, and 26 who did not respond to the hospital letter (total: n=89). These subgroups were randomly recruited for purposeful sampling by disposition decision.

Findings: With an average of 5.1 SFEs, after an average of 8 years of storage, no response came from 60% (n=404) of IVF patients with SFEs. Payment for storage and defrosting were the two most frequent choices (13%, n=89 and 89, respectively) followed by donation to research and transfer (7%, n=47 and 45, respectively). Three common themes emerged from the interviews regarding breaches in communication: the consequences of not returning the disposition letter; lack of communication regarding donation to research; and the unmet wish for donation to infertile couples.

Conclusions: For many patients, not returning the disposition form was a decision intending that the hospital will defrost the SFEs. However, this intention was not communicated, could not be fulfilled, and remained unmet. Second, many IVF patients declined the option of donation to research due to lack of information. Finally, many wanted more information on the option of donation to infertile couples, which they viewed positively.

Recommendations: Changing the contents of the letter sent and providing an accompanying consultation with a multi-professional team including information on donation to research and to other infertile couples.

Research end date: 12/2019