In practice, too, the available options vary greatly depending on where you are. And many of them lead to limbo.
Take Spain, for example, which is a European fertility hub, partly because IVF there is a lot cheaper than in other Western European countries, says Giuliana Baccino, managing director of New Life Bank, a storage facility for eggs and sperm in Buenos Aires, Argentina, and vice chair of the European Fertility Society. Operating costs are low, and there’s healthy competition—there are around 330 IVF clinics operating in Spain. (For comparison, there are around 500 IVF clinics in the US, which has a population almost seven times greater.)
Baccino, who is based in Madrid, says she often hears of foreign patients in their late 40s who create eight or nine embryos for IVF in Spain but end up using only one or two of them. They go back to their home countries to have their babies, and the embryos stay in Spain, she says. These individuals often don’t come back for their remaining embryos, either because they have completed their families or because they age out of IVF eligibility (Spanish clinics tend not to offer the treatment to people over 50).
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In 2023, the Spanish Fertility Society estimated that there were 668,082 embryos in storage in Spain, and that around 60,000 of them were “in a situation of abandonment.” In these cases the clinics might not be able to reach the intended parents, or might not have a clear directive from them, and might not want to destroy any embryos in case the patients ask for them later. But Spanish clinics are wary of discarding embryos even when they have permission to do so, says Baccino. “We always try to avoid trouble,” she says. “And we end up with embryos in this black hole.”
This happens to embryos in the US, too. Clinics can lose touch with their patients, who may move away or forget about their remaining embryos once they have completed their families. Other people may put off making decisions about those embryos and stop communicating with the clinic. In cases like these, clinics tend to hold onto the embryos, covering the storage fees themselves.
Nowadays clinics ask their patients to sign contracts that cover long-term storage of embryos—and the conditions of their disposal. But even with those in hand, it can be easier for clinics to leave the embryos in place indefinitely. “Clinics are wary of disposing of them without explicit consent, because of potential liability,” says Cattapan, who has researched the issue. “People put so much time, energy, money into creating these embryos. What if they come back?”
Bortoletto’s clinic has been in business for 35 years, and the handful of sites it operates in the US have a total of over 47,000 embryos in storage, he says. “Our oldest embryo in storage was frozen in 1989,” he adds.
Some people may not even know where their embryos are. Sam Everingham, who founded and directs Growing Families, an organization offering advice on surrogacy and cross-border donations, traveled with his partner from their home in Melbourne, Australia, to India to find an egg donor and surrogate back in 2009. “It was a Wild West back then,” he recalls. Everingham and his partner used donor eggs to create eight embryos with their sperm.
