Fresh or Frozen Embryo?

ichhori team

Fresh or Frozen Embryo Transfer: Which Is Better?

When planning IVF, one important decision is whether to transfer a fresh embryo or use a thawed, frozen one (FET). Both options work—but each has pros, cons and individual considerations.

What’s the Difference?

  • Fresh transfer: Embryo placed 3–5 days after egg retrieval in the same cycle.
  • Frozen embryo transfer (FET): Embryo frozen and thawed later—weeks, months or even years afterward :contentReference[oaicite:2]{index=2}.

Success Rates & Fertility Outcomes

  • Overall live birth rates are similar between fresh and frozen transfers :contentReference[oaicite:3]{index=3}.
  • Frozen transfers may result in higher pregnancy rates for some groups (e.g. women with PCOS or high responders) :contentReference[oaicite:4]{index=4}.
  • Low‑responders may fare slightly better with fresh transfers :contentReference[oaicite:5]{index=5}.

Neonatal and Obstetric Outcomes

  • Frozen transfers lead to fewer preterm births, low‑birthweight babies and SGA (small-for-gestational-age) infants compared to fresh transfers :contentReference[oaicite:6]{index=6}.
  • FET-born babies may have higher birthweight, but no increase in birth defects or neonatal death :contentReference[oaicite:7]{index=7}.

When Frozen Embryo Transfer Shines

  • Allows time for preimplantation genetic testing (PGT) :contentReference[oaicite:8]{index=8}.
  • Creates a calmer uterine environment by separating from ovarian stimulation :contentReference[oaicite:9]{index=9}.
  • Offers flexibility in timing and reduces stress on patients :contentReference[oaicite:10]{index=10}.

When Fresh Transfer Is Preferable

  • Immediate pregnancy after retrieval—appeals to some couples :contentReference[oaicite:11]{index=11}.
  • No freeze‑thaw process—may boost egg quality in low‑responders :contentReference[oaicite:12]{index=12}.
  • Potentially lower upfront costs—no cryostorage fees :contentReference[oaicite:13]{index=13}.

Health Risks and Considerations

  • Fresh cycles carry risk of ovarian hyperstimulation syndrome (OHSS); freezing embryos can avoid transferring during OHSS-risk period :contentReference[oaicite:14]{index=14}.
  • FET may slightly raise risk of large‑for‑gestational-age births and maternal hypertension :contentReference[oaicite:15]{index=15}.

Cost & Convenience

  • FET adds cryopreservation and storage costs, but avoids repeat egg retrievals :contentReference[oaicite:16]{index=16}.
  • Fresh cycles may cost less initially but may require additional cycles if no embryos remain.

Which Is Best for You?

  • Your age, ovarian response, pregnancy history—even PCOS—may guide the choice.
  • If OHSS risk or endometrial issues exist, FET often makes sense.
  • If you want a faster result, are low‑responder, or previous FETs failed, a fresh transfer may suit better.
  • Discuss embryo quality, genetic testing needs, costs and clinic success rates with your fertility specialist.

Real‑Life Example

Sophie had PCOS and multiple eggs retrieved. Her doctor froze all embryos and did FET later, resulting in a full‑term healthy baby while avoiding OHSS. Meanwhile, Kate, a low‑responder with one embryo, went ahead with a fresh transfer—and conceived on her first try.

FAQs

1. Is FET safer than fresh?
FET lowers risks like preterm birth and low-birthweight for most but may increase large‑baby risks :contentReference[oaicite:17]{index=17}.

2. Does freezing damage embryos?
No—modern vitrification ensures high survival rates, with no increase in defects :contentReference[oaicite:18]{index=18}.

3. Can I do PGT only with FET?
Yes—PGT requires embryos be frozen while awaiting results :contentReference[oaicite:19]{index=19}.

4. What about storage time?
Embryos stored for years still implant well, and outcomes aren't affected by storage duration :contentReference[oaicite:20]{index=20}.

5. When is fresh better?
If you retrieved few eggs, prefer immediate transfer, or your doctor advises a fresh cycle based on your response, fresh may be best.

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Final Thought

There’s no one‑size‑fits‑all answer. Fresh and frozen embryo transfers both lead to healthy, full‑term pregnancies—with advantages for each depending on your health, needs and goals. Discuss your personal situation with your provider—it’s your journey, your choice.

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