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<\/figure><\/div>\n\n\n\n\n\nWhat Is Frozen Embryo Transfer?<\/h2>\n\n\n\n
A frozen embryo transfer is a process in which the embryos generated from an IVF cycle are cryopreserved (frozen) instead of being transferred right away.<\/p>\n\n\n\n
A frozen embryo must be warmed (aka thawed) before it can be transferred back into your uterus at a later date.<\/p>\n\n\n\n
What are the disadvantages of a frozen embryo transfer?<\/h2>\n\n\n\n
There are three main disadvantages with a frozen embryo transfer (FET cycle):<\/p>\n\n\n\n
- Longer time to conception<\/li>
- It can be more costly<\/li>
- Embryos may not survive the freezing and warming process<\/li><\/ol>\n\n\n\n
Let’s go over this one by one.<\/p>\n\n\n\n
1. Frozen embryo transfers delay conception<\/h3>\n\n\n\n
The main disadvantage of a frozen embryo transfer is that it takes longer than a fresh embryo transfer to complete.<\/p>\n\n\n\n
A fresh transfer occurs as early as 3-5 days after the egg retrieval,<\/a> while a frozen transfer won’t happen earlier than 4-6 weeks after the IVF cycle.<\/p>\n\n\n\n
Here is an example of what it can all look like.<\/p>\n\n\n\n
<\/div>\n- January 1st: Day 1 of your period<\/li>
- January 3rd: First Day of IVF injections<\/li>
- January 12th: Final Day of Stimulation – Trigger Shot<\/a> Administered<\/li>
- January 14th: Egg Retrieval<\/li>
- January 19-21: All Blastocysts Embryos Are Frozen<\/li>
- January 28th: Day 1 of your subsequent cycle \/ period.<\/li>
- January 30th: First Day of FET cycle<\/li>
- February 13th: Day of Progesterone Start<\/li>
- February 18th: Frozen Embryo Transfer (of a Blastocyst)<\/li><\/ul>\n<\/div><\/section>\n\n\n\n
<\/div>\n\n\n\nIn contrast, if you chose to have a fresh cycle, you would have had a blastocyst transfer on January 19th and a pregnancy test<\/a> on January 28th.<\/p>\n\n\n\n
I go over an entire FET cycle timeline in this post.<\/a><\/p>\n\n\n\n
Your reproductive endocrinologist<\/a> may also use this time to do any further work-up that hadn’t been optimized or done before, such as a uterine cavity evaluation.<\/p>\n\n\n\n
If an abnormality is found, this will delay your transfer a bit more.<\/p>\n\n\n\n
2. Frozen embryo transfers can be more costly<\/h3>\n\n\n\n
A FET requires an additional treatment cycle after the IVF cycle,<\/a> and this usually means more office visits, more ultrasound monitoring, more blood work, and more medications.<\/p>\n\n\n\n
Fortunately, these visits are less complex, and the medications used are less costly and have fewer side effects.<\/a><\/p>\n\n\n\n
In addition, there is the cost of warming the embryo and preparing you for the transfer itself.<\/p>\n\n\n\n
3. Embryo freezing and thawing survival rates<\/h3>\n\n\n\n
Lastly, FET cycles require that your embryo undergo vitrification (freezing) followed by warming (thawing).<\/p>\n\n\n\n
In a small percentage of cases, some embryos do not survive the thawing process. Thankfully, data indicate that\u00a0over 90% of embryos survive a freeze\/thaw cycle.<\/a><\/p>\n\n\n\n
In my experience, that number is close to 95-98%.<\/p>\n\n\n\n
Frozen embryo transfer advantages<\/h2>\n\n\n\n
Now let’s talk about the benefits or advantages of FET cycles.<\/p>\n\n\n\n
The five biggest advantages are:<\/p>\n\n\n\n
- Allows for scheduling of your family planning<\/li>
- Reduces the need for additional IVF cycles<\/li>
- Allows for preimplantation genetic testing<\/li>
- It decreases the risk of OHSS<\/li>
- It improves endometrial synchrony<\/li><\/ol>\n\n\n\n
1. Frozen embryo transfers are great for patient scheduling<\/strong><\/h3>\n\n\n\n
The main advantage of a frozen embryo transfer is that it allows you to plan ahead, and you can undergo a FET at a time of your convenience.<\/p>\n\n\n\n
For example, you can undergo an IVF cycle to freeze embryos now, but schedule your transfer six months from now after a big trip or event.<\/p>\n\n\n\n
2. Reduces the need for additional IVF treatment cycles<\/strong><\/h3>\n\n\n\n
A FET helps avoid going through another IVF cycle if you happen to generate multiple embryos and you desire more than one child.<\/p>\n\n\n\n
Frozen embryos can be preserved indefinitely and are usable to you and your partner at any point.<\/p>\n\n\n\n
3. Allows for preimplantation genetic testing<\/strong><\/h3>\n\n\n\n
Preimplantation genetic testing (PGT) is a technique in which we biopsy the embryos<\/a> to test for chromosomal abnormalities such as Down syndrome.<\/p>\n\n\n\n
Many early miscarriages or birth defects result from some genetic abnormality, and with genetic testing, we can prevent a large proportion of these.<\/p>\n\n\n\n
With a fresh embryo transfer, there isn’t time to biopsy the embryo and get the results back in time before doing the transfer.<\/p>\n\n\n\n
4. Decreases the risk of ovarian hyperstimulation syndrome<\/strong><\/h3>\n\n\n\n
A small percentage of women will develop ovarian hyperstimulation syndrome during their IVF stimulation cycle.<\/p>\n\n\n\n
This condition is exacerbated if you undergo a fresh embryo transfer<\/a> as OHSS is worsened by beta-hCG, the pregnancy hormone.<\/p>\n\n\n\n
4. It improves endometrial synchrony<\/strong><\/h3>\n\n\n\n
Lastly, a frozen embryo transfer helps synchronize the uterus (or the endometrial lining) with when the embryos are transferred.<\/p>\n\n\n\n
Oftentimes, an IVF cycle can throw off the timing of the hormones necessary for implantation to occur. A FET helps ensure that we place the embryo in the uterus at the right time.<\/p>\n\n\n\n
I go over all of these advantages in more detail in Freeze All IVF Cycles.<\/a><\/p>\n\n\n\n
Is IVF more successful with frozen embryos?<\/h2>\n\n\n\n
Frozen embryo transfers appear to be better than fresh embryo transfers in specific patients, primarily in patients who are high responders.<\/a><\/p>\n\n\n\n
Pregnancy rates and live birth rates (aka the chances of success) are similar for frozen and fresh embryos in almost all other patient groups.<\/p>\n\n\n\n
With that said, you may not be eligible for a fresh transfer if you are:<\/p>\n\n\n\n
- at high risk of OHSS<\/li>
- desire genetic testing of your embryos<\/li>
- your lining or hormone levels are suboptimal for a transfer<\/li><\/ul>\n\n\n\n
What are frozen embryo transfer success rates?<\/h2>\n\n\n\n
Success rates of good quality embryos (blastocysts) can reach 50-60%.<\/a><\/p>\n\n\n\n
These numbers are heavily influenced by:<\/p>\n\n\n\n
- patient age at <\/a>the time of embryo cryopreservation, <\/li>
- embryo quality, <\/li>
- the day the embryo made it to blast stage (day 5,6, or 7)<\/li>
- and patient diagnosis.<\/li><\/ul>\n\n\n\n
Here are some recent studies: [1<\/a>] [2<\/a>] [3<\/a>]<\/p>\n\n\n\n
Other Related Questions<\/h2>\n\n\n\n
What are the risks of freezing embryos?<\/h3>\n\n\n\n
Freezing a blastocyst embryo is a reasonably safe procedure with very minimal risk.<\/p>\n\n\n\n
The main risk of freezing embryos is that they will not survive the thaw.<\/p>\n\n\n\n
If you only had one embryo frozen, then this means you would have to undergo another ovarian stimulation (IVF) cycle to generate more.<\/p>\n\n\n\n
Do frozen embryos have health problems?<\/h3>\n\n\n\n
As far as we can tell, babies generated from frozen embryos have similar outcomes to babies born from fresh embryo transfer cycles.<\/p>\n\n\n\n
One large study published in JAMA in 2020 of over 1 million children found a very small increased risk in some childhood cancers in kids born from frozen embryos.<\/a><\/p>\n\n\n\n
The overall risk of these cancers is about 0.02% in naturally conceived babies. This study found a risk of about 0.04% in those conceived from frozen embryo transfer<\/a>.<\/p>\n\n\n\n
Although this represents a relative risk increase of about 50%, the absolute increase is minimal, and the conditions are rare. In addition, this study demonstrates an association or a correlation, which does not represent causation.<\/p>\n\n\n\n
More research is needed to confirm and expand on these findings.<\/p>\n\n\n\n
How many days after my period is the frozen embryo transfer?<\/h3>\n\n\n\n
- patient age at <\/a>the time of embryo cryopreservation, <\/li>
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