JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):119
Poster Presentation
29th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263753
P-107. Final destination of Cryopreserved Embryos and Gametes in Homologous and Heterologous In Vitro Fertilization Cycles: A Retrospective Study
1 Hospital Moinhos de Vento - Porto Alegre - RS – Brasil
2 Hospital de Clínicas de Porto Alegre - Porto Alegre - RS – Brasil
Objective: To analyze in detail the final destination of cryopreserved embryos and gametes in homologous and heterologous in vitro fertilization (IVF) cycles, considering the frequency and proportion of discard and donation. The study also aimed to identify possible differences between treatment types regarding decisions made, discussing the impact of clinical, ethical, legal, and logistical factors on the decision-making process.
Methods: An observational retrospective study was conducted based on institutional records of IVF cycles performed between December 2019 and April 2024 at a specialized assisted reproduction center. All cases with a documented final decision regarding the fate of cryopreserved embryos and gametes were included. Materials were classified into three categories: discard, donation to the spouse/partner, or donation to another couple. Variables analyzed included the type of treatment (homologous — using the couple's own gametes; heterologous — using donor gametes) and the recorded final fate. Analysis was purely descriptive, with calculation of absolute and relative frequencies for each category. Cases with incomplete data or without a documented final decision were excluded. All procedures for cryopreservation, storage, and subsequent decision-making followed Brazilian legislation and institutional ethical protocols.
Results: A total of 455 cases were evaluated, with 393 (86.4%) from homologous IVF and 62 (13.6%) from heterologous IVF. The most frequent outcome was discard, recorded in 318 cases (69.9%), followed by donation to the spouse/partner in 122 cases (26.8%) and donation to another couple in 15 cases (3.3%). When analyzed separately, in homologous IVF, donation to the spouse was proportionally more common, reflecting the greater possibility of reproductive reuse within the same couple. In heterologous IVF, the relative proportion of donation to another couple was higher, possibly due to the origin of donor gametes, which in some cases facilitates legal transfer to third parties. Discard was frequently associated with older cycles in which patients did not express intent to reuse the material or with decisions made after the reproductive project had concluded. These results demonstrate a predominant pattern of discard, with relevant variations between treatment types, indicating that cycle context and gamete origin directly influence final decisions.
Conclusion: Most cryopreserved embryos and gametes were discarded, followed by donation to the spouse and, to a lesser extent, donation to another couple. Differences between homologous and heterologous treatments indicate a multifactorial decision-making process influenced by legal, ethical, and relational factors such as marital status and future reproductive plans. These findings highlight the importance of clear institutional policies aligned with current legislation, as well as the need for individualized counseling by a multidisciplinary team to support informed decisions consistent with patients' values and reproductive goals. Strengthening these practices may promote more conscious decisions and reduce ethical and emotional conflicts frequently associated with the final fate of cryopreserved embryos and gametes.