Embryo Banking

Good Day to All,

Today I’d like to talk about embryo banking, which means storing as many embryos as you can for later use. It’s a topic that comes up every day in my practice and on the surface it makes sense, just as egg freezing makes sense for the young and unattached.   The typical scenario is of a woman who is committed to a partner or has identified a donor, who wants to become pregnant now, but is concerned, due to her age, that she will not be able to become pregnant again when she wishes a second or even a third. She may be also concerned that if she does become pregnant and has a miscarriage, she will be similarly be placed at a disadvantage due to the loss of time and the advancement of age.   She therefore packs away as many embryos as she can, possibly after preimplantation genetic screening, and is limited only by her tolerance to the IVF process and, of course, finances.

Does this sound like a good idea? Yes, it’s an outstanding idea; it’s proactive, realistic and optimistic. But, it comes with a number of down sides. Is it really worth the trouble? All of us fertility doctors have charts and graphs blaring out the chances of pregnancy based on age, but those are just averages. We can’t know for sure who will and will not have a baby now or 2 years down the road. And what about all women over 35 who are thinking of becoming pregnant on their own, should I seek them out on First Avenue and scream, “Wait, you’re making a big mistake, come in and bank your embryos!”?

While I consider IVF to be one of the true miracles of modern medicine, its effects on a patients psyche is one of medicine’s scourges. On average, things seem to work out wonderfully for most involved, but individually it can be frustrating, disappointing, exhausting; the list goes on. Some who intend to bank are confronted with low egg production or poor embryo development or genetically abnormal embryos or a combination of these all leaving nothing to save. Granted, some would rather know these things sooner rather than later, and are strong enough to consider other options and move on, but some do not appreciate being thrust into a hole, left with uncertainty in their ability to even naturally conceive.

And then there is the cost; embarking on such a process without insurance coverage is a considerable commitment; having coverage is an enviable luxury.

Summarizing, banking could be a smart play. However for many, the negatives may outweigh the positives.  

Dr. Licciardi

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