After giving birth to three healthy boys – followed by seven devastating miscarriages – Amy Janove and her husband Sam were not ready to give up on their dream of having a large family.

Fortunately, there were still many options worth considering, including traditional adoption or more invasive assisted-reproduction procedures. There was also one lesser-known possibility they realized was right for them: using frozen embryos donated by another couple.

“At first we were a little concerned if we would love donor embryo children as much as our genetic children,” admits Amy, a New Jersey resident whose name has been changed for this article.

It was a fleeting fear, however, quickly diminished after talking to other parents who grew their families through embryo donation. And now, as the proud parents of healthy twin boys born in September, they’re already considering adding on to their family with the use of more donor embryos.

“We really would not change anything about the origin of these babies,” says Amy. “They are ours, and we love them just the same as our other children.”

Thirty-seven years after the first baby was conceived by combining egg and sperm outside the human body, in vitro fertilization (IVF) and other techniques to manually fertilize eggs in labs have resulted in more than 200,000 babies – but that’s not all.

A by-product of IVF is the vast number of unused embryos frozen in time. Couples store them for future use as insurance in case the first IVF transfer is unsuccessful or to give themselves the option to have more children. These embryos, which have the potential to develop into children, are stored in liquid nitrogen at hundreds of storage facilities typically connected to infertility clinics nationwide. While it is impossible to know how many frozen embryos exist, estimates put them in the hundreds of thousands to the over one-million mark.

In the eyes of the law, embryos are considered property, not people. And technically, they’re not even embryos but – at up to seven days after fertilization when frozen – blastocysts, or undifferentiated cells. It is up to the couple who opted to freeze the embryos to decide their fate.

In most states, ownership is transferred relatively easily to recipient couples according to contract law. The recipients are recognized as legal parents of any children who are born. And unlike sperm, eggs or even the use of surrogates to aid in the creation of babies, embryos cannot be sold for profit.

For couples facing the dilemma of what to do with their frozen embryos after their own families are complete, donation is one of several options. They could also have them destroyed, donated to science (where permitted) or kept frozen indefinitely at a cost of approximately $600 per year. The fate of these embryos is a personal, complicated and controversial topic that has been tied to abortion politics. Their futures have also embroiled couples in court battles in cases of divorce or the death of one contributing partner. In a well-publicized case this year between actress Sofia Vergara and ex-fiancé Nick Loeb, Loeb is suing the “Modern Family” star to keep her from destroying frozen embryos the couple created during their relationship.

On the other side of the issue are the embryo recipients, who are often couples facing fertility issues and desperately want the chance to have children. A big draw can be the lower price tag relative to an IVF cycle using donor eggs, donor sperm or both. It is also a simpler medical regimen. Since the transfer uses already- formed embryos, there is no need for additional fertility procedures or anesthesia, explains Jerome Check, MD, director of the Cooper Institute for Reproductive Hormonal Disorders.

The approximate cost of implanting a donor embryo is $3,000 at the Cooper Center for In Vitro Fertilization (CCIVF). For IVF, the average cost nationwide is $12,400. If an egg donor is used, it can up the price by tens of thousands of dollars. Similarly, traditional adoption of an infant is expensive – between $8,000 and $40,000, depending on numerous factors, including whether the child was born in another country or domestically.

Beyond the cost factors, donor embryos offer the recipients the opportunity to carry and give birth to their own children and bond immediately. Couples also have some control when choosing their embryo from donor banks that provide both medical information about the donors and information about their ethnic origins. Moreover, the embryos have been tested for viability and common genetic mutations, says George S. Taliadouros, MD, president of the Delaware Valley Institute of Fertility & Genetics (DVIFG).

“Our success rates with frozen embryo transfer is very high, because we selectively freeze only embryos of good quality,” Taliadouros notes.

According to the National Embryo Donation Center (NEDC), the success rate for adopted embryo transfers – involving a healthy embryo and an adoptive mother with no medical obstacles to pregnancy – may be nearly 50 percent, higher than many clinics’ overall IVF success rates.

For Amy, the idea of trying IVF was not palatable, because she didn’t ever want to be in a situation of having to decide what to do with frozen embryos. If she had, she says, she would have either used all the embryos herself or donated them to another couple. Although the couple had not considered a donor embryo, the more they learned about it, the more they realized it was perfect for their family. Because they chose an embryo from parents of a similar ethnic background, the babies look similar to their siblings.

“I know it’s probably really hard for people who have frozen embryos to give them up to another family,” she says. “But giving them a chance of life with another family is just really amazing, and we are so thankful for that.”

Yet of the hundreds of thousands of eggs frozen for couples intending to create life, the vast majority will remain frozen in limbo or end up being destroyed. At CCIVF, for example, of approximately 20,000 frozen embryos, less than 10 a year are released for donation each year.

Check, who would like to encourage more people to donate their unused eggs to infertile couples, says offering financial incentives is problematic because embryos cannot be bought or sold.

He proposed allowing people waiting for donated embryos to at least pay the donor couple up to $1,500 for the cost of storing the embryos. However, the center’s ethics committee shot down the proposal.

The number of people who opt to give up their embryos for donation at DVIFG is relatively small as well. But with the subject less taboo than in the past, more couples seem open to considering donation and more fertility specialists seem willing to recommend it to patients, Taliadouros says.

For couples faced with deciding what to do with their frozen embryos, it is rarely an easy decision to donate. For Lydia and Stephen Burgess of Haddon Township, who froze embryos before Lydia underwent chemotherapy in 2004 at age 32 to treat breast cancer, the moment of reckoning came two years ago. Fortunate to be able to have their two girls without the use of assisted reproductive technology, they were contacted by CCIVF to make a decision. Told that the embryos lose viability after 10 years, they put much thought and discussion into their decision before releasing the embryos for donation.

“It’s obviously not the same thing as carrying a child yourself, but you do feel like they’re your babies,” Lydia says, noting that they requested an open adoption in which the family is required to send pictures and updates on a yearly basis.

Still, it was surreal to learn their embryo resulted in the birth of a healthy biological sibling of her own children who lives in Tennessee with another family they may never meet, Lydia admits. Although they’re not allowed to contact the boy, Lydia is hopeful that someday he will reach out to find them.

“It feels good we were able to help someone,” she says, “and more so that we gave someone a chance at life when we could have just discarded the embryos.”