Frozen Embryo Storage FAQ

What does frozen embryo storage cost? How many frozen embryos can I store? Our patients’ embryo storage FAQs answered.

Along with a steady increase in egg freezing, freezing embryos is also a growing practice. Cryopreservation in fertility medicine is the freezing and storage of eggs, embryos or sperm. Our fertility clinic stores our patients’ frozen embryos (and eggs and sperm) in the cryopreservation system in our IVF lab.

There are benefits to creating and freezing embryos at the time of retrieving eggs to freeze for later use. For instance, freezing embryos can reduce the number of times you need to retrieve eggs. And when you initially freeze eggs, some are probably not going to be adequate for fertilization and shouldn’t be frozen.

We frequently get questions about cryopreservation procedures, and here we will address those frequently asked questions about embryo storage after the freezing process.

Related Reading: Specifics of embryo freezing

Who should consider frozen embryo storage?

People with embryos created through in vitro fertilization (IVF) often have embryos left after a transfer. They often freeze the remaining embryos to use if the transfer does not work or for future pregnancies if the initial embryo transfer is successful. This can greatly reduce the cost of the next pregnancy attempt.

Embryo cryopreservation is a good option for women facing cancer treatments that can damage their eggs and fertility. Some women need to delay a pregnancy attempt due to ovarian hyperstimulation syndrome following egg retrieval.

A woman or couple may want to delay having children, but want to retrieve the woman’s eggs when she is younger and they are more likely to be healthy. This concept also applies to LGBT couples or individuals so they can plan ahead for a family.

We have 12 frozen eggs, so will those become 12 embryos or will it be less?

IVF math is like a funnel: On average we end up with about one-third as many embryos as the starting number of eggs, though this can range significantly among patients. It is rare that 1 egg = 1 healthy/transferrable embryo.

It’s also helpful to know that the high rate of abnormal fertilization in eggs is a natural aspect of human fertilization and not something that any lab can force to happen normally. An abnormally fertilized egg can cause failure to result in a pregnancy, miscarriage or genetic defects in a child. Our embryologists can most often identify abnormally fertilized eggs.

• For patients younger than 35 years old, about 40% of eggs fertilize abnormally.
• In women 35-37 about half of embryos fertilize abnormally.
• In women 38-40 about 70% of eggs fertilize abnormally.
• In women over age 42 about 90% or more of embryos fertilize abnormally.

How many frozen embryos should future parents store?

This depends on the total number of children a person or couple envision having in their family. Ideally, we like to try to help patients have 2-3 embryos stored per child they would like to have. But this can depend on whether the embryos are considered viable for a pregnancy (see below) and whether there is any medical history indicating more challenges for the individual or couple in achieving successful embryo implantation.

In some patients, it isn’t possible or realistic to be able to create several extra embryos, which is the case in older patients, as noted above, or those with diminished ovarian reserve. So, we sometimes have to re-evaluate goals and expectations depending on how egg stimulations progress.

How do you know if an embryo is viable to result in a pregnancy?

We have two ways to evaluate them for viability, giving future parents a better view of potential IVF success. When the embryo forms in the IVF lab, our embryologist performs a careful evaluation of it. This evaluation involves looking at several factors including cell size, extent of cell fragmentation and well-organized compact cells. This allows us to create a grading system for each embryo, which can exclude some for freezing or determine at what stage of development the embryo should be frozen.

Related Reading: More on our lab’s embryo evaluation

The other way to judge viability is more precise: preimplantation genetic testing (PGT). Once an embryo is frozen, we can test its genetics to determine if it has defects that would result in implantation or pregnancy failure, as well as birth defects in a child. Embryos deemed to be at high risk of genetic defects would not be kept and frozen for later use.

Related Reading: Embryo preimplantation genetic testing

How do I know my frozen embryos are secure in TRM’s storage system?

Our embryo storage tanks have a real-time, 24-hour temperature monitoring system and each tank is connected to alarms that notify our staff at any time if something is out of range. The system is web based and easily accessed through a phone app our lab staffers use, enabling remote adjustments.

The storage system and monitoring equipment have backup power systems. We routinely conduct rigorous inspections of the entire system. Further, the embryos are kept in secured locations in the clinic so that the tanks cannot be accessed without staff unlocking the doors in the area where the embryos are stored.

In addition to physical system safeguards, we have strict record-keeping protocols. A record of embryos (also eggs and sperm) in storage is located in two places at all times: the paper chart and the electronic medical records system. Recording the storage of each specimen occurs daily when samples are added to the storage tanks.

Related Reading: Safeguards in our cryopreservation storage

How long can you keep frozen embryos in storage?

We don’t know the length of time an embryo can be stored frozen and still result in pregnancy. Frozen embryos are stored in sealed containers at temperatures that prevent biological processes like aging. In 2022 twins were born to an Oregon couple from embryos that had been frozen for 30 years. Generally, most of our patients use their frozen embryos within 10 years.

What are the options if someone wants to discontinue storage?

• They can choose to donate their embryo(s) to clinical training. In essence this helps improve the quality of IVF care for other infertility patients.
• Embryos can be donated to another person. This can be either a directed/known donation to a specific couple or individual or a non-directed/anonymous donation.
• They can donate embryos to research. This is not currently being performed at TRM but we can guide patients on finding an outside study and coordinate getting the embryo placed in such research studies.
• They can choose to have the embryos discarded.

Are there consent forms one must sign to discontinue storage?

Yes, we have specific consents that must be signed to change the disposition of any embryo. Patients must sign a specific consent that corresponds with the change of disposition option they’ve chosen from the above. Patients choosing to donate their embryos to another person or couple must also complete a medical history form. This anonymous form is provided to the potential recipient(s) to help them when choosing embryos to receive.

What is the frozen embryo storage cost? Are storage costs per embryo?

Our storage fees are $750 per type of specimen (embryos, eggs or sperm). Storage fees are not based on the number of specimens but instead on the type of specimen. If a patient only has frozen embryos, then their annual flat fee is $750 regardless of the number of embryos in our storage. But if a patient has frozen sperm and embryos, then their annual fee would be $1,500. Some facilities charge per number of individual embryos (as well as eggs). But TRM only charges a flat fee per type of specimen.

Do insurance plans typically cover embryo freezing & storage costs? Is there a cap on number of embryos or storage duration?

Yes, some insurance plans include these costs, but the coverage is based on benefits set by the patient’s employer.

• Patients should confirm if there is a lifetime maximum amount or cycle limit.
• If there is a maximum amount, then confirm if it is combined with their treatment medications.
• If the pharmacy benefit is separate, then confirm the Rx lifetime maximum amount.
• Confirm if there are any policy exclusions for treatment services.

There is typically no cap on the numbers of embryo one can store under insurance coverage. Regarding duration of insurance coverage for storage, most plans cover the first year of storage unless it is a policy exclusion.