Parents' conceptualization of their frozen embryos complicates the disposition decision.

Objective: To ascertain what couples think about their embryos and how they approach making a decision about disposition in light of the fact that the disposition of unused frozen embryos has significant implications for medical research and embryo donation.

Design: Ethnographic qualitative interview study.

Setting: Academic research environment.

Patient(s): Fifty-eight couples who had conceived using a donor oocyte and had at least one frozen embryo in storage.

Main Outcome Measure(s): Tape-recorded interviews with 58 wives and 37 husbands were transcribed and analyzed for emergent themes.

Result(s): With an average of 7.1 embryos per couple, after an average of 4.2 years of storage, 72% of couples with frozen embryos had not reached a disposition decision. Most couples had not anticipated or appreciated the consequences of having surplus embryos. Parents variously conceptualized frozen embryos as biologic tissue, living entities, "virtual" children having interests that must be considered and protected, siblings of their living children, genetic or psychological "insurance policies," and symbolic reminders of their past infertility.

Conclusion(s): The disposition decision is not only a significant and frequently unresolved issue for couples with stored frozen embryos, but their deeply personal conceptualizations of their embryos contributes to their ambivalence, uncertainty, and difficulty in reaching a decision.