Examining the fate of frozen embryo inventory: an analysis of patients' embryo disposition decisions.

purposeTo determine factors associated with embryo disposition decisions at a large academic fertility center.

methodsWe performed a single-center retrospective cohort study of patients who made final embryo disposition (discard or donation to research) between January 1, 2020, and February 28, 2024, via electronic consent. Demographic and cycle-specific variables were collected via chart review. Chi-square and Mann-Whitney U tests were used for data analysis (p < 0.05).

resultsOf 1280 patients, 900 (70.3%) discarded embryos and 380 (29.7%) donated to research. Patients who donated were more likely to have a diagnosis of recurrent pregnancy loss (6.1% vs 2.4%, p < 0.002). Patients who chose to donate had transferred more embryos (2 vs 1, p < 0.033) and had transferred more euploid embryos (44.7% vs 36.6%, p < 0.007). There was no difference in total number, number of euploids, or type of embryo disposed (p = 0.24, p = 0.96, p = 0.34). There was no difference observed among those who communicated with the center (p = 0.81) or those using donor gametes (egg p = 0.34, sperm p = 0.29). An additional analysis compared patients who achieved live birth (n = 902) to those who did not (n = 378), and those who donated were more likely to have achieved live birth (32.0% vs 24.1%, p < 0.005). CONCLUSION(S): At final embryo disposition, more patients discarded embryos than donated. Donators were more likely to have recurrent pregnancy loss as their reason for pursuing embryo creation, transfer more embryos across all cycles, and achieve a live birth. Discarders were more likely to have transferred untested or no embryos.