How to facilitate decisions about surplus embryos: patients' views

BACKGROUND: In Victoria, Australia, legislation governing fertility treatment provides that surplus human embryos must not be stored for longer than 5 years. Couples must then choose one of three options: discard, donate to research or donate to another infertile couple. Previous research suggests that many people find these decisions difficult and emotionally distressing. This study aims to elucidate the nature of these difficulties and to identify ways in which the decision-making process could be facilitated. METHODS: This project used a combination of qualitative research methods. In total, 42 people agreed to participate in either a structured interview or a group discussion. All participants had completed IVF treatment and had surplus embryos in storage. The aim of the interviews was to discuss participants' decision making regarding their surplus embryos. Data were thematically analysed. RESULTS: Most participants described the decision-making process as difficult and emotional. Findings indicate that participants could be assisted by more information about each of their current options, and opportunities to talk to others in similar situations. Many responded positively to the idea of having more options, including choice about which research projects to donate to (directed research), and about the recipients of their donated embryos (directed donation). CONCLUSIONS: This study suggests that there are practical ways to assist people in making decisions about their surplus embryos, which could be easily implemented. In addition, the study demonstrated interest in the possibility of directed donation to other couples.