Purpose <p>Advances in assisted reproductive technologies (ART) have led to an increasing number of surplus embryos being cryopreserved. Deciding the fate of these embryos poses complex emotional, ethical, and practical challenges. Understanding the factors that influence these decisions is critical in improving patient counseling and ART policy. This study aimed to analyze patterns in embryo disposition decisions across 6&#xa0;years in a Portuguese ART center, focusing on differences by family type, patient age, and temporal trends.</p> Methods <p>We conducted a retrospective quantitative analysis of embryo disposition forms completed between 2017 and 2022, covering 3494 patients. Data were categorized by year, relationship group (different-sex couples, female couples, and single women), and final decision.</p> Results <p>Disposition decisions vary significantly by relationship group. Female couples were more likely to donate embryos to others (31.8%, <i>p</i> = 0.007) and less likely to discard them (15.9%, <i>p</i> = 0.03) than different-sex couples, who had the highest discard rate (26.5%). Single women showed intermediate behaviors. Age was a significant factor: those who donated embryos, particularly to others, were older (mean = 40.6&#xa0;years) than those who kept or discarded them. No significant differences were found in relation to the number of embryos stored. Temporal analysis showed variation across years, with a notable increase in donations to research in recent years.</p> Conclusions <p>Family type and age are important factors influencing embryo disposition decisions, while the number of embryos appears to have a limited impact.</p>