Perceptions and Attitudes of Parents Who Undergone Fertility Treatments Regarding the Donation of Surplus Fertilized Eggs

The right to parenthood is recognized as a fundamental right in Israel, and consequently, the right to reproduction is perceived as an individual's basic right. Both for these reasons and due to Israel's historical background, the country leads in investments in the development of various fertility treatments, particularly In Vitro Fertilization (IVF).

Israel performs some of the highest numbers of fertility treatments globally relative to the population size. Israeli law permits the freezing and storage of frozen embryos during the IVF process with the written consent of the egg and/or sperm donors, and it is publicly funded for a period of up to five years. By law, after five years, if a written request from the embryo owners is submitted, they can pay the hospital where the embryos are stored in order to extend the storage period for an additional five years. 
The high number of fertility treatments in Israel has led to a new phenomenon known as "surplus frozen embryos," referring to embryos left unused after couples successfully conceive and give birth to as many children as they choose, leaving them with embryos they no longer need. 

The phenomenon of "surplus embryos" presents significant moral and legal dilemmas for both the state, and the couples who need to decide whether to destroy the embryos or preserve them. While the state is required to resolve the legal and ethical aspects accompanying the continued freezing of embryos, as of this writing, there is no enforcement or implementation of the above-mentioned law in Israel. In light of the lack of law enforcement, there is an accumulation of over one million frozen embryos in hospitals without any clear directives. 

Festinger's (1954) Social Comparison Theory suggests that individuals tend to compare their actions to those of others to assess their attitudes and abilities. This comparison can lead to a sense of obligation and strong social pressure, influencing decision-making. Israel, as a pro-natalist state that encourages childbirth, is characterized by significant social pressures, especially regarding issues such as fertility treatments. These pressures may cause parents to feel compelled to continue fertility treatments due to comparisons with others in their community or because of social norms that emphasize the importance of childbirth. 

Additionally, Marcel Mauss’s (1954) Gift Theory relates to social processes of giving and receiving, where giving can enhance social status and strengthen community ties. In the context of embryo donation, the desire to donate surplus frozen embryos may stem from the wish to support others struggling to conceive, aligning with social norms of generosity and reciprocity. This donation is seen as an act that promotes social solidarity and strengthens community bonds but also raises complex ethical dilemmas. 

These two theories together provide a framework for understanding the complexity of decisions related to fertility and embryo donation in Israeli society. They highlight the critical role of social norms, community pressure, and the desire to contribute to the community in individuals' decision-making processes in these matters. 

This study examined the perceptions and attitudes of parents with surplus frozen embryos through a qualitative approach. The research questions focused on three aspects: (1) parents' perceptions regarding the use or non-use of their frozen embryos, (2) their attitudes toward donating embryos to others, and (3) their opinions on current public policy regarding fertility treatments in Israel. The study included semi-structured interviews with 26 participants: six heterosexual couples, four lesbian couples, and six single mothers, all of whom had children born via IVF and were left with frozen embryos. 

Data analysis was conducted using thematic analysis, including coding, identifying themes, and in-depth analysis of patterns emerging from the interviews. Special attention was given to ethical considerations throughout all stages of the research, including maintaining participants' privacy and informed consent. 

The findings chapter revealed three main themes regarding surplus frozen embryos in Israel. The first theme highlights the lack of clear public policy, manifested in the parents' lack of information regarding the use of frozen embryos, diverse perceptions about public funding for embryo freezing, and a crisis of trust in the healthcare system following incidents of mistakes. The second theme focuses on the tension between the national aspirations for high fertility in Israel and personal fears of bringing children into the world during times of war, presenting the unique dilemmas faced by Israeli society in this context. The third theme addresses the challenge of embryo donation and presents a range of participants' opinions, from complete opposition to willingness to donate for research or to other couples. This theme also includes practical suggestions from participants for improving existing policies, such as establishing a governmental body to monitor the fate of frozen embryos, improving communication with couples, creating a computerized registration system, and launching an awareness campaign to raise public understanding of the issue. The findings reflect the emotional, ethical, and social complexity of the issue of frozen embryos in Israel and emphasize the need for the development of a clear and comprehensive policy on the matter.