What a cord blood registry does
A cord blood registry is a company that collects, tests, stores, and maintains your baby's cord blood for potential medical use later. When you bank cord blood with a registry, you are paying that company to keep the sample frozen and viable for decades. The registry handles the paperwork, the lab work to test for infections and cell count, the storage in liquid nitrogen tanks, and the annual fees to keep it stored.
Registries are either private (you pay to store your child's blood for your family's use) or public (you donate it for free, and it goes into a pool anyone needing a match can access). This article focuses on private registries, since those are what most families encounter when they receive marketing materials in the hospital or during pregnancy.
The registry does not treat disease or perform transplants. It stores the blood and releases it only when a doctor orders it for a specific patient at a specific hospital. The actual medical use happens elsewhere, with your child's doctor or a transplant center.
Key Takeaways
- Private cord blood registries charge an upfront collection and processing fee (typically $1,400 to $2,300) plus annual storage fees (typically $100 to $300 per year) for decades.
- The registry tests the sample for sterility, cell viability, and infectious diseases before storing it, and you receive a report of those results.
- You own the sample and control who can use it, but the registry can refuse to release it if storage fees are unpaid or if the sample is no longer viable.
- Public cord blood banks accept donations at no cost to you, but you have no claim to the blood and cannot direct its use to your own child.
- Most insurance does not cover cord blood banking fees, and the medical benefit of storing cord blood for a healthy child remains unproven for most conditions.
How the collection and testing process works
Collection happens when ready after birth, whether you deliver vaginally or by cesarean section. A healthcare provider clamps and cuts the umbilical cord, then draws blood from the cord itself (not from your baby or the placenta). The process takes a few minutes and does not hurt your baby or interfere with standard newborn care.
You arrange collection in advance by contacting the registry and requesting a collection kit. The kit arrives before your due date and contains sterile containers, labels, and instructions. You bring the kit to the hospital and give it to your labor and delivery nurse. After collection, the kit is sealed, labeled with your baby's information, and either picked up by a courier or sent by mail to the registry's laboratory.
At the lab, the registry tests the sample for cell count (viability), bacterial and fungal contamination, and infectious diseases including HIV, hepatitis B and C, syphilis, and others. Testing takes one to two weeks. You receive a report showing whether the sample passed quality standards and is suitable for storage. If the sample fails testing (too few cells, contamination, or infection), the registry will notify you and typically refund your processing fee.
Once testing is complete, the sample is divided into smaller portions, treated with a preservative (usually DMSO, dimethyl sulfoxide), and frozen in liquid nitrogen at minus 196 degrees Celsius. The registry stores these portions in separate tanks so that if one tank fails, your sample is not lost entirely.
What private registries charge and what that covers
Private registries charge two types of fees: an upfront fee for collection and processing, and annual storage fees for as long as you keep the sample stored.
Upfront fees range from roughly $1,400 to $2,300, depending on the registry and any promotional pricing at the time you enroll. This fee covers the collection kit, the lab work to test the sample, and the initial processing and freezing. Some registries offer payment plans that spread the upfront cost over several months.
Annual storage fees typically range from $100 to $300 per year. These fees cover the cost of maintaining the liquid nitrogen tanks, monitoring temperature and equipment, insurance, and staff. Some registries charge a flat annual fee; others charge per year or per decade. A few registries offer a one-time "perpetual storage" fee (often $2,000 to $4,000 additional) that covers storage for life without further annual charges.
Over 20 years, the total cost of private cord blood banking ranges from roughly $3,400 to $8,300, depending on the registry's fee structure and whether you choose perpetual storage. Insurance rarely covers these costs, since cord blood banking is considered elective and preventive rather than treatment for an existing condition.
How you access your stored blood if your child needs it
If your child develops a condition that might benefit from cord blood stem cells, your child's doctor must order the release of the sample. You contact the registry with the doctor's request, and the registry verifies the order with the hospital or transplant center where treatment will occur.
The registry then thaws the sample, performs a final viability test to confirm the cells are still usable, and ships the sample to the treatment facility. Thawing and shipping typically take one to three business days. The registry does not perform the transplant or treatment; that is the responsibility of the medical team at the hospital.
If you stop paying annual storage fees, the registry will typically send you notices and allow a grace period (often 30 to 90 days) before discarding the sample. If you move or change contact information, it is your responsibility to update the registry so they can reach you if there is a problem with the sample or if fees are due.
Private registries versus public cord blood banks
Public cord blood banks accept cord blood donations at no cost to you. The blood is tested, processed, and stored in a public inventory. When someone needs a cord blood transplant and your baby's blood is a genetic match, the public bank releases it for that person's treatment. You have no say in who receives it, and you cannot direct it to your own child if your child later needs it.
Public banks are funded by government, nonprofit organizations, or hospital systems. They do not charge families. However, public banks have limited capacity and do not accept all donations. may be able to access depends on factors like the cell count in the sample, the mother's health history, and the bank's current storage space. Some hospitals have a public bank on-site; others do not.
Private registries store blood exclusively for your family's use. You pay for that exclusivity and for the may provide that the blood will be available to your child if needed. The tradeoff is cost: private storage costs hundreds or thousands of dollars, while public donation is free.
What conditions cord blood has been used to treat
Cord blood stem cells have been used in transplants for blood cancers (leukemia, lymphoma), certain inherited blood disorders, and some immune system disorders. These uses are established and supported by medical evidence. Cord blood transplants for these conditions have been performed for decades and are considered standard treatment options.
Cord blood is also being studied for potential use in cerebral palsy, autism, type 1 diabetes, and other conditions. These studies are ongoing, and the results are not yet conclusive. Marketing materials from some registries mention these potential future uses, but families should understand that these are research applications, not proven treatments.
For a healthy child with no family history of blood disorders or genetic disease, the likelihood of needing their own cord blood is low. The American Academy of Pediatrics recommends private cord blood banking only for families with a known genetic condition or a family history of a disease that cord blood can treat. For families without that history, public banking (if available) is recommended over private banking.
Questions to ask before choosing a registry
Before signing up with a private registry, ask about accreditation. The AABB (American Association of Blood Banks) and the FACT-NetCord organization accredit cord blood banks and set standards for collection, testing, processing, and storage. Accreditation does not may provide the registry will stay in business or that your sample will never be lost, but it does mean the registry meets minimum standards for safety and quality.
Ask what happens if the registry goes out of business. Some registries have agreements with other banks to transfer samples if they close. Others do not. If a registry closes and has no transfer agreement, your sample may be discarded or transferred to a facility you did not choose.
Ask about the registry's track record with sample viability. How many samples stored for 10 years or longer remain viable when thawed? This information is not always public, but reputable registries can provide it or direct you to published studies.
Ask whether the registry will release the sample to a public bank or to another facility if you request it. Some registries allow transfers; others do not. If you think you might want to donate the blood to research or to a public bank later, confirm the registry's policy in advance.
Frequently Asked Questions
Can I use my baby's cord blood if my baby gets sick later?
It depends on the condition. Cord blood from a healthy baby cannot treat genetic diseases the baby was born with, because the baby's own cord blood carries the same genetic mutation. Cord blood can treat blood cancers and some blood disorders that develop later. For most other conditions, cord blood use is still experimental. Talk to your child's doctor about whether banking makes sense for your family's specific situation.
What if I bank cord blood and never use it?
You will have paid the upfront fee and annual storage fees for decades with no medical benefit. The sample will eventually be discarded when you stop paying or when you decide to end storage. Some families view this as insurance they hope never to need; others view it as an unnecessary expense. The decision depends on your family's health history and your comfort with the cost.
Is cord blood banking covered by insurance?
Most health insurance plans do not cover the cost of private cord blood banking, since it is considered elective and preventive. Some employers offer cord blood banking as an optional benefit, sometimes at a discount. Check your insurance plan or your employer's benefits guide to see if coverage is available.
What happens if the registry loses my sample?
Registries carry liability insurance and are required to maintain backup systems and redundant storage. However, loss can happen due to equipment failure, natural disaster, or human error. If your sample is lost, the registry's insurance may cover the cost of recollection and reprocessing if you have another child, but it cannot replace a sample that is already gone. Ask the registry about their insurance coverage and their backup procedures before enrolling.
Can I switch registries if I am unhappy with mine?
Some registries allow you to transfer your sample to another facility; others do not. If transfer is possible, you typically pay a transfer fee and the receiving registry charges its own upfront processing fee. Before signing up, ask whether transfer is an option and what it costs. If you are already banked and want to switch, contact your current registry to ask about their transfer policy.