What Happens to Remaining Embryos?
A trans-centered reflection on navigating the end of family building
This article is offered in partnership with Laura Vladimirova, Clinical Researcher & Psychotherapist at psychesomapractice.com.
Most stories about trans family-building through IVF start at the beginning. This one begins closer to the end.
The early stages of IVF family-building are often focused on when and how to begin. There is so much to consider, so much to plan for, and so many decisions to make. But toward the end of the journey, a different kind of decision may emerge: what to do with the embryos that remain once family-building is complete?
When that question arises, it can open up big feelings, difficult choices, and whole new kinds of conversations.
The process of planning and building a family through IVF can be intense, exciting, and all-consuming. Then, if all goes as hoped, a baby is born. And while emotions are still high and sleep is in painfully short supply, a question often arrives anyway, from a well-meaning guncle or a stranger at the supermarket, “When are you having another?”
And maybe another child does come along. Maybe another after that. At some point, though, people may decide they are done growing their family, as bodies, relationships, finances, or mental health reach a limit. That realization invites another, especially if one or more embryos are still sitting frozen in a cryobank.
As a therapist working closely with trans individuals and families navigating IVF, I’ve found there are few topics that evoke such layered, mixed, and deeply emotional responses as this one. Maybe this is because deciding what to do with remaining embryos touches nearly every domain of the human experience. It’s relational, personal, clinical, legal, and practical, and for many, deeply spiritual. It can raise questions of identity and belonging, bring future decisions into focus sooner than expected, evoke grief, and bring up the question of what it means for a family to feel complete.
None of this is simple to navigate, and it rarely stays in one lane. These are never only logistical or medical decisions. They are deeply relational ones.
Why This May Be Unique for Trans Families
In some trans families, there may be embryos that are genetically linked to one partner and others linked to the other. That can mean that if a family decides not to use the remaining embryos, one partner may already have a genetic connection to an existing child while the other doesn’t. For the partner who isn’t genetically linked, this can bring up grief related to lineage, resemblance, and biological connection, along with more taboo or hard-to-name feelings, like wondering if this decision will impact their connection to their child or children.
Depending on the relationship, a known donor may also have their own sense of what these embryos mean, and thus, feelings about this newly developing decision. Contending with another person in this already sensitive conversation might be meaningful and important, while also adding emotional complexity and labor.
In trans families with multiple partners, there may be questions about whose body is centered, whose genetics carry forward, and whose losses are regarded most acutely. There are distinct things to consider for families that don’t follow a one or two-parent paradigm. Additionally, there are fewer resources available to support mapping and navigating these decisions.
Before moving into discussing the options, it’s important to clearly name that there’s no right or wrong destination for this journey. There is no single perfect answer that resolves every tension. Here, ambivalence doesn’t mean that something is missing or wrong. Instead, it means that multiple things can matter all at the same time. For many, making space for the very real experience of uncertainty can itself be a valid form of care.
Possible Paths
Continuing to pay for and keep remaining embryos in storage, which can function more like a pause rather than an answer. For people who aren’t yet ready to make a permanent decision, where there is disagreement between parties, or if there is a need for more time to process grief or ambiguity, this is a spacious option. While continued storage can bring relief, because it keeps a door to future children open, it can also become a kind of ongoing emotional background noise.
Some people may feel drawn to donating embryos to another family. For trans families, this can feel deeply meaningful, generative, and aligned with values of collaboration and shared possibility. At the same time, embryo donation can bring up complexity, including questions about genetic connection, disclosure, and future relationships. For example: will your child know they are genetically related to another child, and what level of contact, if any, feels right between families over time? There may also be questions about how this fits within your broader sense of family identity. The process itself is often legally and emotionally involved, and typically includes counseling and formal legal agreements.
In some cases, embryos are donated to research. This can offer a sense of purpose or contribution, as people may feel they are supporting scientific knowledge or future care. Donating to research can avoid the relational dynamics involved in donating to another person or family. At the same time, embryos often carry meaning as a possible future, so this decision can still bring up grief, ambivalence, or a sense of closing a chapter, even alongside a sense of purpose.
Compassionate implantation refers to transferring an embryo at a time in the cycle when the body is not able to support a pregnancy, so that it does not implant and is passed from the body. For some people, this can feel more intentional or aligned with how they want to say goodbye to the embryo. It can become a kind of ritualized goodbye, especially when there has been a lot invested in the process. At the same time, it still involves a medical procedure, which can involve risk. It also is not widely available, and can carry both physical and emotional weight. For some, it can bring a sense of closure, for others it might feel more intense or more complicated than expected.
The Broader Context
Ideally, a family making this decision would have all of the options they need available to them. However, the policies and limitations of fertility facilities, state laws, and federal policies also shape timelines and available choices.
Laws around embryos vary by state and shift in response to court decisions. This can affect what clinics allow when it comes to storage, donation, transfer, or disposal. Depending on where embryos are stored, laws may limit options in ways that don’t fully match what a family wants or has imagined.
For trans families specifically, these decisions can also intersect with parentage laws and donor agreements. Many clinics ask people to sign agreements in advance that outline what would happen in situations like separation, divorce, death, or incapacity. In many cases, everyone involved must consent before embryos can be used or discarded. These agreements can offer useful structure, serving as a starting point for discerning conversations. They can also lead to barriers that prevent decision-making down the road if relationships change over time.
Questions Worth Staying With
As you consider how you want to proceed, there are some powerful questions to consider.
What meaning do we assign to embryos?
How do genetics influence our experience as a trans family?
What emotions are we trying to honor, and which might we be trying to avoid?
How might this choice shape future conversations with our children?
How do bodily well-being and risk tolerance factor into this moment?
And, perhaps most importantly: What does closure look like for you?
These are not questions with quick answers. They are invitations to slow down and tune in. It can help to consider what kinds of support feel useful while navigating this area of life, like:
Affirming reproductive therapists or counselors who can offer space to untangle ambivalence
Couples therapy to help partners honor differences
A legal consult to clarify frameworks when information feels confusing
Conversations with other trans parents, in support groups or informally, to normalize feelings that might otherwise feel burdensome or isolating
Taking as much time as needed to think, talk, and feel through all of the options
There is no right or wrong way to have and complete a family. No perfect way to decide you’re “done” having children. While this moment can feel isolating, it’s important to remember that almost everyone who goes through IVF has to ask themselves this same question at some point. If possible, take the time you need to arrive at a decision that reflects your personal and family values, relationships, capacity, and vision for your future. There may never be a “perfect” choice. There may only be a choice you come to live with over time and integrate into the rest of your family’s story.
