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Do fresh embryo's or frozen embryo's have a better success rate of implantation? This question is one to ask when delving into the world of IVF. There is no text book answer, and each of our crystal balls seem to be a little fuzzy when we get to; "What will be successfull for me?." First let me explain a little bit about a fresh transfer and a frozen transfer.
Fresh Embryo Transfer..
A fresh embryo transfer follows your IVF cycle of ovarian stimulation and happens very soon after your initial egg retrieval procedure. Transfer can occur one to six days after successful fertilization. These days, most clinics are allowing the embryo to reach the blastocyst stage before transferring: this is usually on day five or six.
Pro's and Con's to a Fresh Transfer...
- Pro: A fresh transfer is an overall shorter process to get pregnant (if successful). This is a bonus for those of us who are supper impatient. Especially for those who have been waiting a long time to get pregnant. Being that this process occurs right after IVF egg retrieval. It is generally less time for the patient to wait and worry, and if the transfer results in successful implantation it means less time before you have your baby in your arms.
- Con: During ovarian stimulation, hormone levels may be elevated and still be in your system. Meaning that all of the medications and hormones that were taken to help your body develop and mature your eggs for retrieval, may have left your body with higher-than-normal levels of fertility hormones in your system during the time of the transfer. This may sound like good news, but it can actually make it more difficult for an embryo to implant.
- Con: Uterine lining may be less receptive to embryo implantation. There is some recent evidence which suggests that high levels of estrogen may be associated with reduced uterine receptivity. This means that the lining of your womb may not be in an optimal state for implantation, making it more difficult for an embryo to attach.
“Faith makes all things possible.
Love makes everything beautiful,
Hope makes all things work.”
Frozen Embryo Transfer (FET)
Also known as FET, the term actually refers to the use of thawed embryos that were frozen in a previous IVF cycle.
FETs are routinely performed:
- After a failed fresh embryo transfer, when the couple decides they are ready to try again.
- After a successful fresh embryo transfer, when the couple has decided to add another child to their family
FETs save the couple the expense of another full cycle IVF in addition to relieving the woman of the physical and emotional burdens required in undergoing a subsequent fresh IVF cycle.
The FET procedure is successful because it occurs after the woman’s hormone levels have had time to return to normal after her fresh IVF cycle. Versus – the transfer of a fresh embryo after the woman’s body has undergone a regimen of fertility medications.
Whoever said "Money can't buy hapiness" has never learned they can only have children through IVF
Pro's and Con's..
- Pro: Preventing/eliminating late-onset ovarian hyperstimulation syndrome (OHSS). Occasionally, women will have an elevated risk of developing OHSS after egg retrieval and transfer. After the stimulation of your ovaries during your IVF cycle, the addition of human chorionic gonadotropin (hCG) from the pregnancy can trigger OHSS. Though it is usually mild, OHSS causes cysts and the release of large amounts of hormones, including estrogens, progesterone, and local cytokines. Swelling and discomfort are typical in mild cases, while rare severe cases can be dangerous for you and your baby. FET allows us to separate the transfer from the stress of ovarian stimulation, reducing or even eliminating the chance of OHSS.
- Pro: Uterine lining may be more receptive to embryo implantation. Giving your body time to recover from the IVF stimulation cycle and the egg retrieval procedure could mean that the endometrial lining in your womb will be a more ideal environment for implantation to occur.
- Pro: Allowing time for sophisticated genetic test results. If you would like to use preimplantation genetic diagnosis (PGD) or screening (PGS) tests to help ensure that the healthiest embryo is selected for transfer, FET gives the lab time to process the tests and give you time to process the results.
- Pro: Babies born from frozen embryos may have better health outcomes. Studies have shown that FET babies are less likely to be linked to low birth weight and may have a lower chance of being small for their gestational age
- Con: Need to return to clinic after 30 days following egg retrieval for FET. If you are having to take time off of work to attend appointments, or if you need to travel to your clinic, an extra appointment can be an extra inconvenience.
- Con: Additional time to pregnancy. Even an IVF cycle with a fresh embryo transfer can feel endless to a hopeful patient who has been waiting a long time for a baby, so adding another month to the waiting time can seem excruciating.
- Con: Embryo may not survive freezing (or thawing) process. This is the biggest concern for most patients. While there is a chance of embryo loss, with the latest methods and best practices, there is now a survival rate of over 95%. Freezing techniques are a very important consideration, so make sure you know which one your clinic uses. Slow freeze, an older method, has a higher risk of injury or loss. Vitrification, which is a “flash freezing” process, allows embryos to be frozen almost instantly, which prevents most damage.
What about success rates?
These days, frozen embryo transfers have a 15% higher pregnancy rate. This was not always the case, but huge improvements in freezing and storage techniques have closed the gap.
Understanding the pros and cons of both types of transfer should help you feel more prepared when you sit down to discuss your options with your fertility specialist. Whether you and your doctor choose to do a fresh embryo transfer or FET, it is an important milestone in your fertility journey, and I wish you the very best.
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