There may be leftover embryos or eggs from IVF procedures if the person for whom they were originally created has successfully carried one or more pregnancies to term, and no longer wishes to use them. With the patient's permission, these may be donated to help others conceive by means of third party reproduction.
In embryo donation, these extra embryos are given to others for transfer, with the goal of producing a successful pregnancy. Embryo recipients have genetic issues or poor-quality embryos or eggs of their own. The resulting child is considered the child of whoever birthed them, and not the child of the donor, the same as occurs with egg donation or sperm donation. As per The National Infertility Association, typically, genetic parents donate the eggs or embryos to a fertility clinic where they are preserved by oocyte cryopreservation or embryo cryopreservation until a carrier is found for them. The process of matching the donation with the prospective parents is conducted by the agency itself, at which time the clinic transfers ownership of the embryos to the prospective parent(s).
Alternatives to donating unused embryos are destroying them (or having them transferred at a time when pregnancy is very unlikely), keeping them frozen indefinitely, or donating them for use in research (rendering them non-viable). Individual moral views on disposing of leftover embryos may depend on personal views on the beginning of human personhood and the definition and/or value of potential future persons, and on the value that is given to fundamental research questions. Some people believe donation of leftover embryos for research is a good alternative to discarding the embryos when patients receive proper, honest and clear information about the research project, the procedures and the scientific values.
During the embryo selection and transfer phases, many embryos may be discarded in favour of others. This selection may be based on criteria such as genetic disorders or the sex. One of the earliest cases of special gene selection through IVF was the case of the Collins family in the 1990s, who selected the sex of their child.
The ethic issues remain unresolved as no worldwide consensus exists in science, religion, and philosophy on when a human embryo should be recognised as a person. For those who believe that this is at the moment of conception, IVF becomes a moral question when multiple eggs are fertilised, begin development, and only a few are chosen for uterus transfer.
If IVF were to involve the fertilisation of only a single egg, or at least only the number that will be transferred, then this would not be an issue. However, this has the chance of increasing costs dramatically as only a few eggs can be attempted at a time.  As a result, the couple must decide what to do with these extra embryos. Depending on their view of the embryo's humanity or the chance the couple will want to try to have another child, the couple has multiple options for dealing with these extra embryos. Couples can choose to keep them frozen, donate them to other infertile couples, thaw them, or donate them to medical research. Keeping them frozen costs money, donating them does not ensure they will survive, thawing them renders them immediately unviable, and medical research results in their termination. In the realm of medical research, the couple is not necessarily told what the embryos will be used for, and as a result, some can be used in stem cell research.
In February 2024, the Alabama Supreme Court ruled in LePage v. Center for Reproductive Medicine that cryopreserved embryos were "persons" or "extrauterine children". After Dobbs v. Jackson Women's Health Organization (2022), some antiabortionists had hoped to get a judgement that fetuses and embryos were "person[s]".