Key Reminder: No longer suitable for embryo transfer.

Elaine C. Meyer, a 63-year-old clinical psychologist at Boston Children's Hospital in the U.S., faced a critical decision: Should she keep her two frozen IVF embryos that had been stored at the hospital for 25 years? The hospital had sent a notice stating they would be discarded unless storage fees were renewed.

More than 40 years have passed since the birth of the world's first test-tube baby. Due to delayed childbearing ages and increasing infertility rates, many countries and regions, including China, are facing an urgent problem: frozen embryo storage facilities are running out of space.

The "Chinese Expert Consensus on the Duration of Frozen Embryo Storage" recommends a storage period not exceeding 10 years. However, early this year, several major hospitals' reproductive centers in Zhengzhou, Henan Province discovered hundreds of thousands of abandoned frozen embryos during inventory checks. On December 14, 2020, the PLA 73rd Group Army Hospital announced plans to dispose of expired frozen embryos, with the first batch totaling over ten thousand specimens stored before 2010—exceeding the 10-year limit.

"I had no idea. In 2000, the hospital clearly told me all embryos had been used. But over a decade later, they were found in the storage tank." Recently, Meyer told The New York Times that she and her husband Barry Prizant have filed a lawsuit in Rhode Island Superior Court against Women & Infants Hospital of Providence. They allege the hospital breached contract terms and was negligent, resulting in the loss of "irreplaceable property," and are seeking compensation for emotional distress.

In 1985, the Ohio Supreme Court in the United States ruled in the case of Werling v. Sandy that a successful and healthy embryo is considered a person from the day of conception. "According to the hospital's feedback, these two embryos were not properly preserved over the past decade and can no longer be used for embryo transfer. This is equivalent to murder. We cannot accept it," Pleasant said.

The hospital involved responded to *The New York Times* with a statement denying any breach of contract. A hospital spokesperson declined to provide further information, citing patient privacy concerns.

Meyer and Pleasant met in 1985. At the time, both were attending an academic conference at a psychiatric hospital. Pleasant, who specialized in childhood and adult autism, frequently delivered memorable lines during his presentation, catching Meyer's attention.

In 1987, the couple married and agreed to wait until Meyer completed her doctoral research before having children. The wait lasted five years. At age 34, Meyer became pregnant but soon suffered a miscarriage. This was followed by two more miscarriages of unknown cause.

In 1995, the couple followed professional advice and went to see Dr. Gary Frishman at Women & Infants Hospital in Providence, Rhode Island, to undergo IVF treatment. Injections, ultrasounds, egg retrieval, fertilization, cultivation, implantation... It wasn't until the third cycle that a tiny life finally took root in Mayer's uterus.

In December 1996, Noah was born. The couple signed an agreement with the hospital to freeze the remaining 9 embryos from that cycle for potential future pregnancies.

"They were like sparks of life, drawing me in," Mayer said. She would occasionally drive to the hospital. Sitting in her car in the parking lot, she would hum lullabies. "I knew we'd come back for another child."

When Noah was 4 years old, the couple returned to Dr. Frishman. This time, the hospital said they would thaw all the remaining embryos and transfer them into Mayer's uterus.

A few weeks later, the ultrasound showed the transfer had failed. David Keefe, then director of the hospital's Reproductive Medicine department, suggested the couple consider egg donation, IVF, or adoption. "You're already 43," Meyer recalled Keefe saying.

Her husband, Prichard, refused. "Most of our patients are children. Perhaps having just one child would allow us more time and energy to care for more young patients."

The family's happiness was shattered in July 2017. That day, Meyer received a letter from Providence Women & Children's Hospital beginning with "Dear Patient..." She tossed it into a drawer. She mentioned the letter to her husband, but neither thought much of it.

In August, a second letter arrived. It stated: "If you wish the hospital to continue storing your cryopreserved IVF embryos, please sign the enclosed form and return it with a $500 storage fee."

Mayer immediately called the hospital to request verification. Several weeks later, she was told, "After checking with the reproductive medicine laboratory, we confirm you still have two frozen IVF embryos."

After a brief silence, Mayer responded, "Do you realize how serious this is?" She then hung up the phone.

A few days later, she spoke with Dr. Ruben Alvero, then director of the hospital's reproductive medicine department. "After repeated verification, we confirm you do have two frozen embryos," Alvero stated.

That December, Alvero invited the Mayers for an in-person meeting at the hospital. Dr. Frischman, Mayer's primary physician, was unable to attend the meeting due to personal circumstances.

Alvero stated that the two frozen embryos were stored in a small glass vial labeled with Meyer's name. The vial fell into the cryo-tank's water basin for unknown reasons. It was discovered during tank maintenance in 2010 and subsequently returned to the cryogenic storage unit. In 2017, the laboratory introduced new fee standards for frozen embryo preservation and subsequently sent the Meyers a bill.

The hospital reported that the most recent laboratory examination showed the embryos' cell membranes remained intact. However, the vial had developed a crack, which potentially indicated prolonged exposure of the frozen embryos to nitrogen coolant.

Alvero stated that if the couple requires it, the hospital will provide them with free embryo cryopreservation services.

During the on-site communication, Meyer found a handwritten note in her medical file that read "2, missing." "You knew the embryos were lost, but didn't tell us?" she demanded.

However, the hospital insisted they had informed the couple, suggesting they might have forgotten.

"We had considered adoption and using donor eggs for IVF. If we'd known two embryos were missing, why wouldn't we have discussed searching for them first?" Meyer told The New York Times, noting she had been teaching bioethics courses at medical school for years. Had she known about the two missing embryos, how could she have possibly "calmly forgotten" such a thing.

The New York Times contacted Dr. Kiev, the former director who had already stepped down. He stated he was unaware of the incident. "In extremely rare cases, embryos may indeed be discarded or misplaced. We would immediately notify the patients, apologize, and provide detailed explanations about what might have occurred. Transparency is the foundation of trust and a fundamental element of the doctor-patient relationship."

During the same meeting in December 2017, the hospital stated they would coordinate with administrative departments to invite Meyer to conduct bioethics training aimed at improving physician-patient communication skills among reproductive medicine staff. In the following five months, the Meyers received no further communication from the hospital. Subsequently, Meyer wrote to the hospital: "We have not forgotten that our embryos were once lost." This email was copied to the hospital's CEO, the Rhode Island Attorney General, and the director of the state's health department.

Shortly after sending the letter, the hospital's risk management director called Meyer: "That happened a long time ago. Try to forget it."

"This call crossed the line. Those were the crystallization of our love with my husband, and they could have grown into human beings." After deliberation, Meyer and her husband decided to sue, demanding compensation from the hospital for emotional distress. "We also hope to raise awareness about the preservation of frozen embryos and encourage assisted reproductive technology institutions to adopt more reliable and responsible storage management."

Couples Considering IVF: Please Note—Have You Ever Lost an Embryo?_39 Health Network_Infertility Jeffrey Kahn, director of the Johns Hopkins Berman Institute of Bioethics, is not acquainted with the Meyer and Pleasant couple nor involved in their lawsuit. He stated that the couple's experience could be described as "legendary," adding, "but this may not be uncommon."

In 2020, the journal *Fertility and Sterility* published a study stating that in the past 10 years, there had been 133 lawsuits related to the loss, disposal, or damage of frozen embryos. Dov Fox, one of the study's authors and director of the Center for Health Law Policy and Bioethics at the University of San Diego, noted that most cases were settled out of court. Due to confidentiality agreements, the outcomes are difficult to ascertain.

Among the 133 cases, Providence Women & Infants Hospital was repeatedly named as a defendant. Records from the Rhode Island Superior Court indicate that in the 2002 case *Frisina v. Providence Women & Infants Hospital*, three women whose frozen embryos were accidentally lost or destroyed were listed as co-plaintiffs. The incidents occurred in 1991, 1992, and 1993. Subsequently, in 2019, the hospital faced another lawsuit. The plaintiff, Marisa Cloutier Bristol, had an experience strikingly similar to that of the Mayers. "In 2017, I suddenly received a hospital bill stating that my frozen embryos required a renewal fee. But in 2003, the hospital had clearly stated that no remaining embryos existed."

Bristol told "Good Morning America": "My husband is dead. I'm all alone, heartbroken over a child we could have had." In 2020, the case was dismissed. Bristol declined The New York Times' interview request through her attorney.

On March 3, 2018, due to a power outage in a storage freezer at University Hospitals Ahuja Medical Center in Ohio, USA, all 4,000 frozen embryos stored there were destroyed. Although the hospital stated it was willing to take responsibility and compensate accordingly, one of the affected couples, Wendy and Rick Penniman, still filed a lawsuit. "They treated the embryos as chattel, not as patients. This isn't just about rights and obligations—it's about emotions and life itself."

As of the publication of this article, no court judgments regarding the loss or damage of frozen embryos have been released on platforms such as the "Judgment Documents Network." Professor Sun Liangguo from the Jilin University School of Law expressed his views on frozen embryos in the Journal of National Prosecutors College: An entity within eight weeks of pregnancy is referred to as an "embryo," while after eight weeks, it is called a "fetus." Embryos represent only the earliest stage of developmental biology. Under Chinese law, the concept of a "person" is quite strict, limited to a fetus that is alive at birth. "Frozen embryos" do not possess the necessary "life characteristics" required in the definition of a "person." "But they are also not equivalent to objects, as they have the potential to develop into human beings," wrote Sun Liangguo.

Due to the COVID-19 pandemic, the Meyer couple's case has been delayed. "We plan to retrieve the two embryos and bury them in a cemetery to give them peace," Meyer said.