What is Embryo Donation & Adoption?

By BSc, MSc (embryologist), MD, MSc (gynecologist), MD, FACOG, FACS, FACE (reproductive endocrinologist) and BA, MA (fertility counselor).
Last Update: 11/15/2016

Embryo adoption is an infertility treatment by which a couple tries to conceive using the leftover embryos from another couple's in vitro fertilization (IVF) cycle. Unused embryos are donated by couples who have chosen this option in an act of altruism. For this reason, it is also known as embryo donation, as one couple donates while the receiving couple adopts them.

In this sense, we can distinguish between:

  • Embryo donation, from the perspective of the individual or couple donating their unused embryos from IVF to other couples.
  • Embryo adoption, if seen from the point of view of the person or couple receiving the embryos from another couple to have a baby.

Below you have an index with the 8 points we are going to deal with in this article.

What happens to unused embryos in IVF?

When couples undergo an in vitro fertilization (IVF) cycle, female patients are prescribed fertility medications to induce ovulation. By doing this, multiple eggs of high-quality are produced, thereby increasing their chances of getting pregnant.

Out of all the embryos obtained, only those with an excellent quality are selected for being transferred to the mother's womb, so that they hopefully implant and lead to a successful pregnancy.

Commonly, between 1 and 2 embryos are transferred, although the most advisable is betting on single embryo transfers (SET) to avoid multiple births, always depending on each particular case. The extra embryos, as long as they present good quality, are referred to as unused, leftover, spare or surplus embryos, and can be cryopreserved (frozen) by means of embryo vitrification.

Couples should decide what to do with their unused frozen embryos after IVF. Their fate can be one of the following:

  • Cryopreserving them for later use
  • Donating them for reproductive purposes, i.e. embryo donation for being used in another couple's IVF treatment.
  • Donating them for stem cell research
  • The embryos are destroyed by the fertility clinic. This option is available only if the woman is not on childbearing age anymore.

Broadly speaking, the first is usually the option of choice for most couples. However, if they do not wish to have more children, deciding to donate their frozen embryos as an alternative for other couples to create a family.

In such case, the embryos are thawed and transferred to the recipient's uterus.

Pros and cons of embryo adoption

The main advantages for couple suffering from infertility who consider the possibility of adopting embryos are:

  • Simplicity of the process: Neither ovarian stimulation nor follicular puncture is required.
  • Cost: Given that unused embryos from another IVF cycle are used, the cost of this fertility treatment is substantially lower than that of a conventional IVF cycle, and far lower than IVF using donor eggs and/or donor sperm.
  • Medications: In this case, the necessary medications are not administered intravenously but orally, vaginally or in patch form.

Despite all these advantages, it should be clear that embryo donation has a major disadvantage as well: they are the leftover embryos from a couple with fertility problems which are used. This means that the success rates of this fertility treatment are not as high as for example those of IVF with donor eggs or donor sperm.

The success rate of embryo adoption with frozen embryos is around 24%.

On the other hand, patients who decide to start a fertility treatment using embryo donation and adoption should not only understand but also come to terms with the fact that the DNA of these embryos is not theirs. Many couples need psychological support and counseling to cope with it, either from the ethical, moral, religious and/or personal point of view.

How to adopt an embryo: process step by step

The treatment followed for embryo adoption is easier as that of an IVF cycle using the couple’s own gametes and similar to the donor egg/sperm IVF procedure.

  • Preparation of the endometrium: the recipient gets hormone medications either vaginally, orally or in patch form. This hormone therapy will help improving endometrial thickness, which is the mucosal lining of the uterus in which the embryo implants.
  • Embryo transfer (ET): once the endometrium has developed a trilaminar appearance and its thickness reaches 7-10 mm, the embryo transfer will be carried out. ET is a simple, painless procedure, and it does not take too long.

After the embryo transfer, the only thing left to do is waiting for the embryos to implant into the mother’s uterus, which means that pregnancy will have occurred. It is important to allow at least 10 days after the ET before doing the home pregnancy test to check whether the treatment has been successful.

Success rates of embryo adoption programs

The success rates using embryos donated by another couple rely on their quality to a large extent. In this case, even though they have an influence as well, the characteristics of the recipient are not so important.

Nowadays, specialists are able to reach high survival rates after embryo thawing, as vitrification reduces the embryos vulnerability and allows them to recover fully in 90% of the cases. In spite of that, it should be clear that these embryos have been created from the gametes of couples with fertility issues, and therefore the odds for pregnancy are not too high. To be precise, they range between 20-30% approximately.

There is also the possibility that a couple decides to donate the frozen embryos created for them with donor eggs and/or sperm for their IVF treatment. In such cases, embryo quality would be improved, and so the chances of becoming pregnant.

On the other hand, before deciding to use donated embryos, couples are encouraged to be completely sure that they will not experience feelings of grief or regret when they realize they are not going to share their genetic code with their baby. Moreover, they should understand the bioethical aspects of the process, as well as the morality surrounding it.

How much to adopt an embryo

As explained earlier, adopting an embryo is an alternative for reducing the cost of an IVF treatment. Embryo adoption is, as a matter of fact, a lower cost adoption choice if we compare it to IVF with donor eggs, or domestic/international adoption.

The costs of embryo donation and adoption are mainly paid by the receiving family, while donating families do not receive payment for their donation, as it is an altruistic act above all. Adopting families are usually asked to pay for storage fees once the match is made.

On average, the cost of embryo adoption ranges from €1,700 to 3,000 in countries like Spain. It depends on factors such as the fertility clinic, the screening process and special tests required, each person's or couple's situation, etc.

Outside Europe, the overall cost of embryo adoption may be higher (from $7,500) and should be broken down as follows:

  • Agency fees (including legal fees, embryo shipping, matching services, additional medical screening, counseling...)
  • Home study or family evaluation
  • Frozen Embryo Transfer (FET)

More often than not, the overall cost of the treatment does not include the medications fees for the preparation of the endometrial lining. The price is usually around €200-300.

FAQs from users

With an embryo donation, can I have problems of incompatibility or rejection of these embryos?

By Mark P. Trolice MD, FACOG, FACS, FACE (reproductive endocrinologist).

Rearkably, a woman’s uterus does not reject an embryo, even though it is half “foreign” due to fertilization by the mans’ sperm. More fascinating, the uterus accepts an embryo from a double-donation of egg and sperm. There are theories to explain why a woman’s uterus does not reject the embryo as foreign but no definitive reason has emerged.

Are the physical characteristics of both couples taken into account when the matching for embryo adoption is done?

By Andrea Rodrigo BSc, MSc (embryologist).

Yes, both in cases of gamete donation (eggs and sperm) and embryo donation, the medical team tries to match the physical characteristics of the donor with those of the recipient (e.g. blood type).

Is embryo adoption a valid choice for pro-life Catholics?

By Andrea Rodrigo BSc, MSc (embryologist).

The pro-life side of the Catholic Church is in favor of what they refer to as prenatal adoption, that is, adopting another couple's unused embryos from IVF.

Each year, over 600,000 embryos are thrown away only in the United States, so embryo adoption is a very valid option for Catholic families who suffer from infertility and wish to build their family through an alternative method.

In this sense, there exist various associations such as "Snowflakes Embryo Adoption and Donation", created by Nightlight Christian Adoptions, which pioneered embryo adoption in 1997. More than 480 babies have been born ever since.

For more information, please visit the following post: Religious views on gamete donation and embryo adoption.

Does embryo adoption qualify for tax credit?

By Andrea Rodrigo BSc, MSc (embryologist).

In the United States, embryo donation is not considered an adoption, but rather a property transfer by state laws. Taking this into account, those who adopt an embryo are not eligible for an adoption credit. However, the state of Georgia has enacted an statute called "Option of Adoption Act", which has made some couples eligible for Federal Adoption Tax Credit.

Are there embryo donation databases to assist in matching donated embryos to patients?

By Andrea Rodrigo BSc, MSc (embryologist).

Yes, there are donor embryo banks that allow you to search for embryos which characteristics resemble yours. Some even post pictures of the biological parents, while others are more private.

Online donor embryo banks assist in matching donated embryos to patients with whom they share a similar profile.

Donor embryo vs. donor egg, what is better?

By Andrea Rodrigo BSc, MSc (embryologist).

No technique is better than the other; it just depends on the characteristics of each patient and what is causing infertility. For instance, in cases where the male partner produces good-quality sperm, egg donation would be the most advisable treatment, as this allows for at least one of the intended parents to share his DNA with future offspring.

On the other hand, if both partners are infertile, double-donor IVF or embryo adoption would be the options of choice. In the former, the eggs and the sperms are of an excellent quality, as they both have been created using donor gametes. As for the latter, it involves using the spare embryos from the IVF cycle of another couple; although it is more affordable from the financial point of view, its success depends on the quality of the adopted embryos. Conversely, outcomes obtained by donation are usually satisfactory, but are dependent on the uterine conditions of the recipient.

As can be seen, several factors have an influence on such decision, so examining each case individually to determine what may be the most suitable option according to medical, economical and psychological aspects is crucial.

Should surplus IVF embryos be donated to stem cell research?

By Andrea Rodrigo BSc, MSc (embryologist).

Yes, embryo donation for stem cell research is a possible fate for surplus embryos. By choosing donating them for stem cell research, their cells can be used in research for tissue and organ development in vitro, which could help save lives in the future.

Are there options for an open embryo donation?

By Andrea Rodrigo BSc, MSc (embryologist).

Yes, open embryo donation is allowed in some countries. In that case, it works more similarly to traditional adoption of a live child. It is a more expensive process and requires a greater level of participation, though.

Given that an open embryo donation agreement is required, participants are required to seek legal representation.

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Authors and contributors

 Andrea Rodrigo
Andrea Rodrigo
BSc, MSc
Bachelor's Degree in Biotechnology from the Polytechnic University of Valencia. Master's Degree in Biotechnology of Human Assisted Reproduction from the University of Valencia along with the Valencian Infertility Institute (IVI). Postgraduate course in Medical Genetics. More information about Andrea Rodrigo
 Elena de la Fuente Díez
Elena de la Fuente Díez
Bachelor's Degree in Medicine from the University of Valladolid, with Ph.D in Obstetrics & Gynecology from the University of Valencia, and Master's Degree in Advanced Gynecological Endoscopic Surgery from the University of Augvergne. Physician specialized in Obstetrics & Gynecology, and currently works as an associate doctor at the Assisted Reproduction Unit of Ginemed Valencia (Hospital Vithas 9 de Octubre of Valencia). More information about Elena de la Fuente Díez
License: 462855729
 Mark P. Trolice
Mark P. Trolice
Reproductive Endocrinologist
Mark P. Trolice is the Director of Fertility CARE – The IVF Center and Clinical Associate Professor in the Department of Obstetrics & Gynecology (OB/GYN) at the University of Central Florida College of Medicine. He is Board-certified in REI and OB/GYN, and maintains annual recertification. His colleagues select him as Top Doctor in America® annually, one among the top 5% of doctors in the U.S. More information about Mark P. Trolice
License: ME 78893
Adapted into english by:
 Sandra Fernández
Sandra Fernández
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

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