Parents’ conceptualization of their frozen embryos complicates the disposition decision

Nachtigall, Robert D.; Becker, Gay; Friese, Carrie; Butler, Anneliese; MacDougall, Kirstin

doi:10.1016/j.fertnstert.2005.01.134

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Volume 84, Issue 2 , Pages 431-434, August 2005

Parents’ conceptualization of their frozen embryos complicates the disposition decision

Presented at the 59th Annual Meeting of the American Society for Reproductive Medicine, San Antonio, Texas, October 11–15, 2003.

Robert D. Nachtigall, M.D.
- Institute of Health and Aging, University of California, San Francisco, California
- Reprint requests: Robert D. Nachtigall, M.D., Institute of Health and Aging, University of California, San Francisco, 3333 California Street, Suite 340, San Francisco, California 94118-0646 (FAX: 415-502-5208).
Gay Becker, Ph.D.
- Department of Anthropology, History, and Social Medicine, University of California, San Francisco, California
Carrie Friese, B.A.
- Department of Social and Behavioral Sciences, University of California, San Francisco, California
Anneliese Butler, B.A.
- Department of Social Work, Bryn Mawr College, Bryn Mawr, Pennsylvania
Kirstin MacDougall, M.F.A.
- Institute of Health and Aging, University of California, San Francisco, California

Received 20 October 2004; received in revised form 27 January 2005; accepted 27 January 2005.

Objective

To ascertain what couples think about their embryos and how they approach making a decision about disposition in light of the fact that the disposition of unused frozen embryos has significant implications for medical research and embryo donation.

Design

Ethnographic qualitative interview study.

Setting

Academic research environment.

Patient(s)

Fifty-eight couples who had conceived using a donor oocyte and had at least one frozen embryo in storage.

Main Outcome Measure(s)

Tape-recorded interviews with 58 wives and 37 husbands were transcribed and analyzed for emergent themes.

Result(s)

With an average of 7.1 embryos per couple, after an average of 4.2 years of storage, 72% of couples with frozen embryos had not reached a disposition decision. Most couples had not anticipated or appreciated the consequences of having surplus embryos. Parents variously conceptualized frozen embryos as biologic tissue, living entities, “virtual” children having interests that must be considered and protected, siblings of their living children, genetic or psychological “insurance policies,” and symbolic reminders of their past infertility.

Conclusion(s)

The disposition decision is not only a significant and frequently unresolved issue for couples with stored frozen embryos, but their deeply personal conceptualizations of their embryos contributes to their ambivalence, uncertainty, and difficulty in reaching a decision.

Key Words: Frozen embryos , embryo donation , embryo disposition