ASRM Scientific Congress & Expo (P-506) The Fate of Supernumerary Cryopreserved Embryos: Insights Into Couple’s Disposition Decisions   ASRM Scientific Congress & Expo November 1st, 2017 Kathryn Coyne, MD, Emerly TH Luong, BS, Miryoung Lee, Ph.D., Jody Lynee Madeira, JD, Ph.D, Ami S. Jaeger, JD, J Preston Parry, MD, MPH, and Steven R. Lindheim, MD, MMM

Background IVF cycles frequently produce supernumerary embryos that may be cryopreserved for future use Dispositions include the fate of embryos following Death of a partner or Dissolution of Current Relationship (DiCR) Embryo disposition options include Donation to Partner (DtP) Donation to Research Embryo donation to other couples (EmD) Destruction Factors that may affect embryo dispositions Complexity of informed consent process The medical and emotional complexity of determining the fate of embryos Perceived relationship to their embryos and their moral implications

Aim Disposition decisions are reputably difficult and patients are likely to choose different dispositions in the event of death and dissolution of an existing relationship We aim to assess patients’ wishes, attitudes, values, and factors predicting their decisions following Death or DiCR

Methods Mixed method research study from November 2011 through August 2014 Quantitative patient surveys (n=267) and qualitative interviews with both patients (n=130) were conducted Patients were recruited through flyers and online fertility forums Questions addressed ED options and comparisons were made for Death and DiCR Data was further analyzed based on age, primary income, IVF payment method, religion, and number of IVF cycles

Results Significantly more patients would donate their cryopreserved embryos to their partner after Death than DiCR More patients would donate to research in the event of DiCR than in Death Patients were twice as likely to choose destruction following DiCR than Death Partners wanted to make a different choice 10% of the time

Results Income & Payment Method Patients with primary incomes between $50K-$100K were 57% less likely to prefer PAR as compared to those with incomes over $100K Those who paid in cash were 2.4 times more likely to choose PAR Patients with a religious affiliation chose destruction more frequently than non-religious patients following Death IVF Payment Methods Those paying in cash in whole or part were less likely to allow EmD and preferred DtP Number of IVF Cycles Patients undergoing more IVF cycles on average tended to prefer Destruction following DiCR

Conclusion Patients’ perceptions of their relationship influence their embryo disposition decisions Income, religious beliefs, payment method, and number of IVF cycles can be predictive factors of embryo disposition decisions It is important to assess factors that influence patients’ decisions given their potential emotional connection and investment in the fate of their embryos Given the associated legal, ethical, and moral implications of EDi, proactive counseling during and after ART may help patients to make desired decisions and reach their goals