We gave them our leftover frozen embryos. Now, we’re a family.

“Would you like to hold her?” Lisa asks.

Having travelled more than 4,500 kilometres from B.C. to Quebec with my husband, Tyler, to meet three-month-old Emma, I drop my suitcase and bound toward her, my arms open wide. Emma’s large dark eyes and ski-jump nose pop out of her blanket with the same spunk that our two sons showed at that age. It’s hard not to notice all the similarities—she is my sons’ full genetic sibling, after all. But unlike our children, Emma didn’t grow in my body and my husband and I are not her parents.

Emma is the daughter of Lisa and Norbert.

Even still, when Emma’s and my matching brown eyes connect, my body erupts in that kind of love parents feel when we realize our hearts now live outside ourselves in the most fragile and uncontrollable container of a child. And while the utter precariousness of this love is terrifying, even maddening, it’s also the most alive feeling many of us could ever desire.

But this is not a love story about shared blood. It’s about the love between two couples, strangers on opposite sides of the country, spiralling for years through the same fear: that we may never have children in our family to love. And now we’re surrounded by more family than we had ever imagined.

***

I grew up in a family that compensated for its tiny size by collecting a vibrant group of strays around a long dinner table, whether for weekday dinners, holiday feasts or stays of months and years. Family was a loose concept, defined more by sharing our lives than sharing our genes.

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It was at that crowded table at Christmas in 2012 when Tyler and I announced we were finally pregnant, news that had immediately erased from our minds the anguish of five years of scary diagnoses, surgeries, hospital stays, drugs and, finally, in-vitro fertilization. Amid excited congratulations, we boasted that we still had six high-quality embryos to transfer into my womb when we wished to expand our family.

A family friend across the table immediately stiffened. “But what will you do with any leftover embryos?” she asked.

We’d never thought about this before. Instead, we had fixated on one thing: having enough embryos to create our family.

There comes a point in the fertility journey when you realize it’s all you think about. The identity of “infertile” fits so snugly that you can’t believe you could ever shed it. It’s almost like the constant loss and disappointment convince you that continuing on is worth it: why else would you put yourself through this? Somewhere along the way a belief sets in that a child is the only thing in the world that will make your life matter. Until then, you are simply a life on hold, waiting.

I was ambivalent about having children before I knew I couldn’t. I was fulfilled in work, love and play. But infertility changed my narrative from that of someone who had enough to someone who was missing “the one thing.” So for us, each egg harvested through IVF had the power to make this painful process stop. And all I wanted was to make it stop.

***

Five days after our fertility doctor extracted eggs from my body, we had seven healthy embryos (fertilized with my husband’s sperm) or, more specifically, blastocysts—blobs of 70 to 100 cells, ready to be transferred back into my body to create our family. My first son was born nine months later. We had a second son soon after, an unexpected natural conception, which is a surprisingly common occurrence after IVF, our doctor told us.

Finally, our fertility journey could stop.

Our family was complete, and we now defined ourselves as exhausted parents. With children born so close together, people asked if they were twins, and when corrected, they said we must be exceptionally fertile. This became my new identity, as my mind was eager to forget the struggle to get us there.

But then I started waking up to the same dream: my children were locked in a freezer. For weeks, the nightmare persisted. I explored it with my therapist; we assumed my work was bleeding into my dreams. By then, I was back to work as a psychiatrist, providing psychotherapy for people who have experienced extreme traumatic events, including murder and torture.

On my way out of the therapist’s office, I mentioned that it was time to pay the annual fee to keep our embryos frozen.

“Your family in the freezer,” she reminded me.

***

Every year, a form arrived in the mail. Would we like to keep storing the frozen embryos at the clinic, dispose of them or donate them to science? We had no religious or ethical objections to any of the options, and yet year after year we chose the decision of making no decision: to keep freezing.

We’re not the only ones facing this dilemma. One in six prospective parents faces infertility, pushing many down the path of IVF in order to start their families. And only one in four people gets pregnant per IVF cycle started, according to the 2016 Canadian Assisted Reproductive Registry, with many others having no success after many cycles. So in the fertility field there is no shoot-for-the-middle culture that strives to make just enough embryos—no one knows how many will be needed before a baby is born. “Five embryos may be created and it might not be until the fourth try that we get success,” says Dr. Jason Hitkari, president of the Canadian Fertility and Andrology Society and medical director at the Olive Fertility Clinic in Vancouver. “Then you need to account for people who want more than one baby.”

There are no records of the number of frozen embryos currently being stored in fertility clinics in Canada. Mary Howlett Nero, the embryo donation program coordinator at Beginnings Family Services in Ontario, estimates that around 100,000 embryos sit in limbo in this country, extrapolating from the roughly one million embryos many have said remain frozen in the U.S. But U.S. estimates are flawed, notes Alana Cattapan, a professor at the University of Waterloo and the Canada Research Chair in the Politics of Reproduction. “We just don’t know,” she says.

While disposal of embryos is the preferred option for most, the choice of not choosing is also common, leaving leftover embryos in “indefinite cryopreservation,” says Hitkari. And, as rates of infertility and the use of fertility services climb in Canada each year, more and more embryos are frozen, maintaining their quality for decades— a healthy baby girl was recently conceived in Tennessee from a 27-year-old donated embryo. Sometimes fertility clinics are left holding the legal and ethical nightmare of storing embryos even after their patients discontinue contact.

Many countries are responding to this predicament by introducing legislation to cap the length of time surplus embryos are allowed to stay in storage, ranging from one to 10 years. In 2015, In 2015, Cattapan advocated for Canada to improve clarity in consent procedures when prospective parents begin IVF and to legislate time limits on embryo storage, allowing for extensions when appropriate. With the exception of Quebec, where an act passed in 2009 allows fertility clinics to “conserve, donate, transfer or dispose of” embryos if the patients have not been in contact for more than five years, Canada has not adopted any such limits.

One possible solution to a surplus of embryos is donating them to another individual or couple who can’t conceive on their own. The first reports of embryo donation were in 1983, the same year that freezing embryos became possible. The process is described as less medically risky, less expensive and possibly offering better chances of pregnancy than other fertility options. But uptake for embryo donation is still relatively slow.

The process itself brings controversy, as it’s been tied to religious and cultural debates around interfering with nature or God’s will and what constitutes human life. Even within pro-life religious groups, embryo donation can be seen as moral (saving an embryo) or immoral (playing God). Yet as assisted reproductive technology has advanced over time, so have social attitudes toward it, and processes such as embryo donation have gradually won the status of effective standards of treatment in mainstream medicine in Canada. Still, the number of people who have donated embryos is so small that those who go this route can feel like they’re embarking on a social experiment.

Fiona MacCallum, a psychology researcher at England’s University of Warwick, is one of the first to study children conceived by embryo donation. Her research into the well-being of these children up to middle school is reassuring: the families “were all doing well,” and are not significantly different from other families, MacCallum says. Research out of New Zealand has been similarly promising. Children of families interviewed by Sonja Goedeke, a psychologist at the Auckland University of Technology who has been researching embryo donation since 2007, are well adjusted socially, developmentally and psychologically.

But the children Goedeke and her colleagues have studied are still young. And while more follow-up studies will come out, “the fact that there’s not much long-term research on what children born under arrangements like this will make of it does make some people quite reluctant,” says Goedeke. “You’ve got to hold and tolerate a degree of uncertainty and be comfortable with it.”

***

My fertility clinic had previously offered anonymous donations, but I was turned off by the thought of spending the next decades wondering if every brunette child I saw in the grocery store was my genetic offspring. With anonymous donations, we wouldn’t even know if we had other offspring out there in the world. And what if one of our children somehow met and married their genetic sibling?

As I searched online for alternatives to having a family in the freezer forever, I found Beginnings Family Services, an adoption agency which also offers an embryo donation program that has helped families give birth to 34 babies. Beginnings, I learned, is the only organization in Canada to offer open embryo donations, where donor and recipient families communicate openly, rather than staying anonymous.

And that’s when my nightmares stopped.

We immediately applied to Beginnings as embryo donors. The questionnaires were extensive. Prospective recipients were to learn not only our sociocultural backgrounds, medical history, ages and faiths, but also our participation in sports, the arts and even our favourite colours, songs and movies, all to offer recipients a taste of our temperaments, values, lifestyles and personalities. As embryo donors and recipients are deciding to enter a lifelong relationship together, choosing the right family can feel as important as choosing the right spouse.

Howlett Nero met with us to evaluate our appropriateness for the program. She ensures prospective donors are certain about their decision and prepared for the emotional implications of donating their embryos to another family “who will end up raising a child that could have been theirs.” She asks about any criteria the donors have for the recipient family and talks about expectations for the future relationship for them and their children, explaining how “openness” works.

Openness is widely accepted as the gold standard for adoption and is likewise becoming the recommended approach for embryo donation, Howlett Nero says. Studies show that open adoption supports children’s psychological well-being and identity development, reduces behavioural problems and improves communication and trust between children and parents. The experiences of sperm- or egg-only donated children also guide the practices of embryo donation. As adults, many have argued that they have a right to their conception history and genetic information.

It’s secrecy in families that leads to difficulties more than anything else, says Goedeke. “Secrecy and anonymity create a whole lot of issues [for children] around the burden of daily secrets, feeling betrayed by their parents and not having access to all the information about their identity.” Secrets not only affect the wellness of the child, but the wellness of the family, she adds.

But disclosure isn’t always easy. MacCallum’s 2012 study showed that embryo donation parents were far more reluctant than adoptive parents to tell their children about their genetic origins. While adoptive parents are equipped with child-friendly scripts and props, parents of children of embryo donation are often concerned that their young children won’t be able to understand the mechanics of conception.

In any case, anonymity is a dying concept, says the University of Montreal’s Vardit Ravitsky, president of the International Association of Bioethics, with the combination of direct-to-consumer genetic testing, such as 23andMe and AncestryDNA, and social media. “What we’re seeing more and more is somebody might contact [the donor’s] mom, or their sister or their aunt, and say, ‘Hey, we’re related.’ ”

Howlett Nero emailed us profiles of prospective recipients she felt would be a good fit for us. I opened the first one—sitting in my car in a mall parking lot—the moment it arrived in my inbox.

A picture of Lisa and Norbert filled my screen. They were snuggling baby goats, one of my obsessions. Norbert sounded eerily like me. He was known by friends around the world for his big smile. He described years of travels, getting completely enthralled by projects and an inability to stay still. Lisa’s profile felt like Tyler: she was open, sensitive, hard-working and loved to learn. The last page of their profile featured a picture of a long table. It said: “We view the open relationship with the donor couple as an extension of our own family. We understand that our children’s genetic parents, siblings, aunts, uncles, cousins, etc. may very well all be present in our lives to a certain extent. This is like a larger network of connections for our children, and we view this all as a definite positive.”

I had gone into this process hoping to find our embryos a loving family. But now we were finding a loving family for ourselves, too.

***

Lisa and Norbert had been a couple for less than two weeks when they began talking about having a family together. (They asked that their last names not be used in this story to protect their children’s privacy.) They met in Montreal through a mutual friend when they were both 38. “It was love at first word. Our values and direction brought us very close, very fast,” says Lisa.

They moved in together after six months with the desire to start a family. When they didn’t get pregnant on their own after many cycles of trying, their doctor referred them to a fertility clinic. They both underwent invasive fertility procedures and began the lengthy process of applying to adopt.

Finally, their fertility doctor “had the talk with us,” says Lisa. He told them: “You might want to start visualizing your future differently.”

But then he remembered a presentation on embryo donation at the annual fertility conference where Howlett Nero had spoken only days before. Norbert protected himself from being too optimistic. “Our hopes had been crushed like 12 or 15 times in the past,” he says. But they decided to try it. Why not take one more step?

They applied to Beginnings a few months before we did. “It might’ve been minutes after you sent in your paperwork that Mary was in touch with us,” Lisa says. “She knew. She never told us that she knew. She just passed it on and let the magic happen.”

We quickly met Lisa and Norbert over Skype, with Howlett Nero facilitating. Then we began chatting regularly on our own, and between the pictures that we frequently shared of baby animals, Ottolenghi recipes, vegetables growing in our gardens and all of us playing outdoors, we realized how alike we were in terms of values, culture and community.

“We found our family soul mates,” says Lisa. “We complete each other in a way that is beyond a regular love story: it has love and family.”

Goedeke’s research shows that part of making the process feel acceptable to donors is ensuring their embryos go into “good hands.” Beginnings shares with donors the recipients’ home-study assessment, which is similar to that conducted for parents hoping to adopt a child, and looks at social, psychological and financial stability in addition to criminal and child welfare checks. Both donors and recipients need to agree on the match, and either may decline potential pairings.

Part of what can make for an easy connection is that the parents often come from the same journey. The only difference is that IVF worked for one couple but not the other. Embryo donation can be a way of sharing the luck.

But Lisa and Norbert were also helping us. While many clinics and children’s books present the narrative of donors as “kind people who gave us a gift,” Goedeke and MacCallum argue that, in the case of embryo donations, this tells only one side of the story, creating unhelpful expectations of recipients feeling indebted to donors. It’s actually a mutual exchange.

Lisa went into labour just before Christmas. She and Norbert Skyped us from the delivery room. Then a long silence. As the hours passed, my anxiety grew: something was wrong. Meditating under my Christmas tree, I realized the gravity of my love for Lisa, Norbert and their baby, and also how separate they were from us. This was their journey now.

Soon after Emma was born, we received a photo of her, healthy in her mother’s arms.

Many friends expressed fears about us going through this process. So much can go wrong, they warned. What if the recipient family doesn’t honour the openness agreement? What if we don’t get along? What if the children want nothing to do with us when they grow up? What if it’s too painful to watch your genetic offspring grow up in someone else’s arms?

These are all real possibilities. I do dream that our connection with Lisa and Norbert and Emma will continue over decades. We love to imagine Emma knowing she can always rely on us in the way families do. But I also see our rich relationship with each other as an unexpected bonus of giving our embryos a chance at life: it’s free to wax and wane over our lifetimes, as all relationships may. We really don’t know how it’s going to turn out.

***

Christina Stapper and her husband, Benjamin, are the embryo donors for Beginnings’ first successful embryo transfer. They were at a New Year’s party almost a decade ago when the conversation turned to difficulties conceiving. They mentioned that after five years of trying they were finally successful at IVF, but now felt torn about what to do with their leftover frozen embryos. Elly Jaspers-Fayer and her husband, Don, who had endured years of unsuccessful attempts at pregnancy, left that party thinking, “Wouldn’t it be neat if we could have their embryos?”

A few weeks later, the Jaspers-Fayers received a handwritten letter in the mail from Stapper asking, “Would you consider this crazy idea of adopting our embryos?”

“I couldn’t get Elly and Don out of my head after that party,” says Stapper.

Through fertility procedures, Stapper and her husband had conceived three children of their own, and they were left with 15 leftover embryos. “In no other circumstance would we give up a child,” says Stapper. “But there’s no way we could have that many children. It’s just not physically possible or financially viable.”

And yet, like me, Stapper couldn’t forget her embryos. “They were emotionally with me all the time,” she says. “I had this recurring dream of me just walking, walking, walking with this little cooler. It was the embryos and they were always in my hand.”

Both couples live in Ontario, so Jaspers-Fayer suggested they meet in person and “it really clicked,” she says. “This is what God has planned for us.”

Stapper and her husband explored all the “what ifs” in counselling as a couple and with the Jaspers-Fayers. “It was extremely helpful, because it brought up things you don’t necessarily think about,” says Stapper. Ultimately, they decided the negatives couldn’t outweigh the possibilities. “Even if we can never see or know this child, we have to believe—and this is true for our own children too—that they are not our possession,” she says. “We can’t predict what our relationship with our own children is going to be in 10 years. [Donating our embryos] was just letting go a lot earlier.”

When the first baby was born, Stapper and her husband were among the first people Jaspers-Fayer called, and the donor couple jumped into their car to go and meet him. “Elly handed him over to me and left the room for two hours,” Stapper says. “I didn’t really start thinking about all those scenarios from counselling until I was holding him in my arms. ‘What if I’ve put you in a place that’s not where you’re supposed to be?’ That’s when those questions really hit me.”

But as she continued to cradle the child who could have been hers, she felt herself letting go.

Goedeke, having interviewed numerous embryo donors and recipients for her research, acknowledges the potential for future problems. Donors may grapple with an ongoing sense of responsibility for the donor offspring, despite having no role in raising them, she says. Depending on the process in a given jurisdiction, some have concerns with parent suitability, for example, when no formal assessment is conducted. When donors choose donation as the “least unattractive” or “last resort” choice, says Goedeke, they may continue to feel ambivalent about the decision.

Sometimes the relationship between donor and recipient families deteriorates, especially around different expectations related to disclosure, differences in belief systems and parenting choices, socioeconomic backgrounds and access to opportunities for the children. Recipients may worry about donors maintaining appropriate boundaries and feel obligated to agree to more contact or information exchange than they are comfortable with, Goedeke says.

And some recipients feel grief around their lack of genetic connection to the child. Embryo donation ignites heated discussions of what constitutes kinship, reflecting both personal and cultural belief systems. Goedeke’s research in New Zealand, for example, is influenced by the Maori culture, which gives genetic connectedness tremendous importance, she says.

Goedeke found that those who managed best saw the donor as an extended family member, “someone who has no rights over the donor-conceived offspring but can express interest in the well-being of the child,” because, as she says, “that’s what extended family does.” Most of the donors she studied were very clear that the donor-conceived children were not theirs. Most made sense of the relationship by identifying as an aunt or uncle or godparent. “Though they do say, ‘They are my children’s siblings,’ ” says Goedeke. And the donor family’s children would frequently refer to the donor-conceived children in the recipient’s family as their sisters or brothers, she adds.

The Stappers and Jaspers-Fayers see each other as extended family in exactly this way. Still, Stapper grieves every time she says goodbye to the Jaspers-Fayers’ two children. “I want people to know this is a viable option, but I also don’t want others to feel the heartbreak. It’s not an easy thing that you can decide in a moment. It’s going to have lifelong effects,” she says.

After the Jaspers-Fayers family was complete with two children, Stapper and her husband still had many embryos left. “Going through the journey with Don and Elly has been wonderful, but we decided that was enough,” she says. “Last summer we called the clinic and allowed the embryos to be released [unthawed]. We had a little time as a family to say goodbye. And I’m truly at peace with it.”

In a way, nothing had changed from before the embryo donation, she adds, only that there were fewer embryos. “It was still the same embryos in the same freezer, paying that same fee every year to keep them there,” she says. “But now I have peace.”

***

For our first Christmas after meeting Lisa and Norbert, I gave them a framed picture of a lotus flower, a symbol that carried solace for me throughout the struggles of my life. Underneath it, I wrote, “Out of the mud blooms the most beautiful flower.” They sent us back a picture of Emma lying next to the photo. I keep it on our dresser.

Our two families regularly chat, visit and exchange photos and videos of our kids. I love to show them to my close friends and family. They gush with me, but continue to worry: “How is this for you? It must be so hard.”

But it isn’t. At least not yet.

***

“Do you like the artwork hanging on our wall? It’s an Emma original. She mixed the paint. She managed to perfectly colour-match the couch,” Lisa says over Skype. “I think she’s a full-on genius. Anything she’s going to put her mind to, she’s going to make it happen.”

It’s April of this year and Lisa and Norbert are chatting with me and Tyler on Skype. This time we’re marvelling not just over Emma but over their new baby boy as well, who’s also our children’s full genetic sibling.

“There are the four of us parents, and now there are the four of them,” says Lisa. “We’ll all be together: us having a great time, and I’m counting on them having a great time together too!”

“But it’s going to be up to them,” says Norbert.

In the meantime, there is an outstanding question that is up to all four of us to answer: what to do with our two remaining leftover embryos?

We’d initially all assumed we’d donate again to another family, but we’ve started to admit that our tables are very full. It’s hard to imagine opening up our hearts again at this intensity, finding another fit as perfect as the one we have with Lisa and Norbert, or balancing the complex dynamics of a third family of siblings to our children.

I realize I haven’t even thought of the embryos in some time and, like Christina Stapper, I’m at peace with letting them go.

But for now, the easiest decision is to make no decision. So the embryos are going to wait in the freezer a little while longer.

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This article appears in print in the October 2021 issue of Maclean’s magazine with the headline, “All (y)our children.” Subscribe to the monthly print magazine here.