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This study describes patients' satisfaction with the information they received regarding the disposition of supernumerary embryos in the context of their decision making, as well as partners' roles and the involvement of others. An anonymous mail questionnaire was sent to 412 female patients from the Department of Reproductive Medicine (Ghent University Hospital, Ghent, Belgium). The questionnaire had a response rate of 79%. The majority of patients who did not want to continue the storage of their embryos (87.9%) thought the information provided was sufficient to make a decision. Patients who were not satisfied more often failed to reach a decision compared to other patients (4/25 vs. 6/173, p = 0.0248). The majority of couples (81.7%) reached a decision jointly between partners. Nonetheless, in 15.6% of couples, one of the partners had made the decision alone, mostly after consulting their partners. Only a minority of the couples (13.2%) consulted others (mostly family members or close friends), suggesting that patients view these decisions as a private matter. Only 1.1% of all patients had talked to someone at the centre about their decision. To conclude, for most patients, the information provided was adequate in light of their disposition decision making. Overall, patients' decision making appears to be a private matter which happens out of sight from medical staff, making it hard to assist patients who face difficulties.

Objectives: This paper describes a recently identified conception of the cryopreserved embryo as a symbol of one's relationship (SOR)., Methods: A questionnaire was sent together with the embryo disposition decision (EDD) form to patients for whom embryos were cryopreserved at the department in Ghent, Belgium. We collected data on patient characteristics, their EDD attitudes and the reasons for their willingness or unwillingness to consider each of the disposition options (donation to others for reproduction, donation for science and discarding)., Results: The SOR view was found more often in patients who were less educated and whose last treatment was less than 3 years ago. Viewing the embryo as a SOR was not linked to more difficult decision making, but to more emotionally loaded decision making. In particular, patients with this view more often reported feelings of grief. This view was also linked to the outcome of the decision making process., Conclusion: The conception of the embryo as a SOR is part of an affective attitude towards embryos that has an impact on patients' disposition decisions. Alongside patients' values and principles, it is important that counselors acknowledge and clarify patients' affective conceptualizations.

Objective: To describe patients who at least once did not reply to correspondence of the center about embryo disposition., Design: Anonymous questionnaire., Setting: Department of Reproductive Medicine, Ghent University Hospital (Belgium)., Patient(s): Patients whose embryos were stored for at least 2 years., Intervention(s): Mail survey., Main Outcome Measure(s): Patients' reply behavior, their characteristics, their embryo disposition decision, and their attitudes toward this decision., Result(s): The response rate was 79%. Twelve percent of the patients were nonrepliers, mostly because they were not able to reach a (joint) decision. Nonrepliers were somewhat older, their last treatment cycle was longer ago, and it more often had a negative outcome. Nonrepliers were childless twice as often as other patients. They also more often experienced anticipated regret about the decision, and they valued their embryos more often in relation to the use for their own treatment. The proportion of patients who seldom thought about their embryos was the same in both groups., Conclusion(s): Treatment failure, anticipated regret, and valuing the embryo on the basis of probability of use influence patients' reply behavior and may be key elements for prevention measures., (Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)