IVF programs and embryo storage: New technologies and old public health issues

More than 25 years has passed since the first infant conceived through IVF was born in the United States. Since that time, the number of IVF programs has dramatically increased. Cryopreservation is offered to families who have additional embryos following IVF and wish to store them for possible future use. In recent years, programs have faced difficulties with embryo storage including families being lost to follow up and their embryos being abandoned. A multidisciplinary team, comprised of faculty in law, medicine and public health sciences initiated a study to learn how IVF programs were educating and counseling families about cryopreservation, the informed consent procedures and agreements used by the program, and the problems programs have experienced with embryo storage. A national survey was conducted with over 100 participating IVF programs. All participating programs reported offering cryopreservation. Almost half (47.5 %) indicated that their cryopreservation agreement includes detailed contact information for the parents i.e. individuals who would how to reach the family for the next five years. Approximately one third (34.3 %) reported that the agreement states the methods and the number of attempts the program would use locate the parents if the storage time frame had expired. Even with their cryopreservation agreements collecting this detailed follow up information, 48.5 % of the programs indicated that embryo storage had posed problems for their program. This paper will highlight the types of problems faced by programs along with suggested public health policy approaches for this growing issue for families and programs.