Many of them had already endured their share of heartache. Some had been trying for years to get pregnant, suffering through multiple miscarriages. Others had undergone cancer treatments that destroyed their fertility.
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Now, hundreds of these women and couples have learned that the eggs and embryos they froze for eventual use in starting or expanding a family may have been destroyed by storage tank failures March 4 at two fertility clinics in suburban Cleveland and San Francisco.
Authorities are investigating what went wrong to cause the biggest such loss in the U.S. since in vitro fertilization began nearly four decades ago. But some of these patients at University Hospitals Cleveland Medical Center and the Pacific Fertility Clinic fear their last, best chance of having children may be gone.
Marlo Emch didn't grow up with a brother or sister near her age. That's why she desperately wanted another child after giving birth last April to a son conceived through in vitro fertilization.
She imagined her son having a partner to help navigate life and someone who would be there after she and her husband were gone. "It makes me sad to think he may never have a sibling close to his age," she said.
Emch and her husband, Jeremy, married in their late 30s and struggled to have a child, losing one pregnancy after three months, before turning to a fertility clinic.
"People who are able to conceive naturally have no idea of the level of despair a woman has when they can't become pregnant," she said.
Everything worked perfectly with the birth of their son, and they planned trying for just one more this spring until being told last week that their seven remaining embryos may no longer be viable.
The couple, both now 42, won't know until the embryos are thawed and tested.
"Chances are very, very low. The mother in me has to find out for sure. I almost feel like I'm going to have to grieve all over again," said Emch, who lives in Burton, Ohio.
Since receiving the devastating news, she started a Facebook support group open to the 700 affected patients from the suburban Cleveland clinic.
One woman told of how her husband has died since the couple froze their embryos. "That was her last connection to him," Emch said.
Before undergoing chemotherapy at age 23 for a rare cancer that affects bones and soft tissue, Elliott Ash decided to have his sperm frozen.
He hadn't even met his future wife but knew he wanted children someday.
Married five years ago, he and his wife decided in 2014 to start the process of having a child through in vitro fertilization while in their early 30s. Their son was born the next year, and two frozen embryos remained in storage at University Hospitals.
"In an instant, everything was taken away," said Amber Ash.
Doctors have told the couple the embryos did not survive the thaw.
Her first thought was about her son and his lost opportunity to have a genetic sibling.
While her husband's cancer is in remission, chemotherapy left him sterile. Creating new embryos with his sperm is no longer an option.
The Bay Village, Ohio, couple was among the first to sue the hospital.
"So many of us were cheated, cheated of the opportunity to start families or expand our families," said Amber Ash. "Our motive really is we want to prevent this from happening again. To prevent another family from going through this complete nightmare."
Cameron Michalak and his wife, Amber, spent close to eight frustrating years trying to have a baby — both naturally and through fertilization treatments.
When nothing they tried worked, their doctor advised that their best and maybe only chance for a pregnancy would be through in vitro fertilization.
Expensive and exhaustive, the process took over their lives. Family and friends in the Cleveland area raised $13,000 through a GoFundMe campaign.
There were hundreds of injections, multiple times per day for Amber. Strict schedules for the waves of drugs. Another failure on the first round. And then more shots after Amber became pregnant with a girl due in April.
"Extraordinarily invasive," said Cameron Michalak. "I wouldn't wish that on her ever again."
Now, though, it's a decision they may face again.
The couple had five frozen embryos — created by combining their eggs and sperm — that were frozen and stored in the failed tank. Now, repeating the process may be their only shot at having another child.
University Hospitals is offering to help patients with new fertility treatments.
That may still be an option for the Michalaks, who live in Vermillion, Ohio, because both are 34, but that might not be true for older patients. Others are deciding whether it's worth risking additional health complications.
"That was my first thought, all of the people who have not had a chance to have success yet," said Cameron Michalak. "All of the people who don't have the time to wait or their time is now."
Katie Miller has had two children using her frozen embryos and was starting treatments at Pacific Fertility Clinic so she could have a third when she was got an email saying something went wrong.
She was among 500 people who have been told their embryos were in a storage tank that had dangerously low liquid nitrogen levels. The clinic said the embryos were transferred to a new tank.
"You don't even think about what's happening in the lab. You just assume that that's really being taken care of and that's not something to worry about," Miller told KGO-TV in San Francisco.
The extent of the damage has not been disclosed.
"There really are so many questions at this point, and hopefully there will be some good news," she said. "But at the same time, there have to be people who have already received probably very devastating news."
Associated Press writer Olga Rodriguez in San Francisco contributed to this report.