Fresh vs frozen embryo transfer – are the success rates the same?

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3 fertility expert(s) answered this question

Answer from: Raúl Olivares, MD

Gynaecologist, Medical Director & Owner Barcelona IVF
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Fresh and frozen embryo transfers should offer the same pregnancy rates as long as you work with blastocysts – the embryos on day 5. The new freezing technique – vitrification – has completely changed the scenario. With this technique, blastocysts have a survival rate higher than 98%. When we have problems during an egg donation cycle, for example, a breakthrough bleeding or when we feel that there is a really high risk of having hyperstimulation syndrome during IVF, we don’t mind freezing all the embryos.

We know that the first cryotransfer is going to offer the patients the same success rates as the fresh embryo transfer. As we have never observed better pregnancy rates in frozen embryo transfers, we don’t share the policies of freezing all the embryos in all cycles (offered by some clinics). In our opinion, the impact of high levels of estrogens, which we sometimes get during IVF, is not enough to impair the implantation rates. We do not want to manipulate the embryos if it is not strictly necessary. As long as there is no high risk of hyperstimulation syndrome, we still carry out fresh embryo transfers in IVF with very good results.

Answer from: Maria Arquè, MD

Gynaecologist, (Former clinic) Medical Director Reproclinic
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Nowadays, success rates with fresh embryos or frozen embryos are pretty much the same when we speak about blastocysts. There is emerging data saying that those are consistent results.

Therefore, what we tend to do many times is to use frozen embryos instead of fresh embryos. On the other hand, especially when we’re doing IVF with our own eggs, one of the hypotheses why success rates for frozen embryo transfers are a little better is that all the levels of estradiol are more natural and similar to a natural cycle – even if we are doing a medicated one. That might also impact the expression of some genes that are related to receptivity. Therefore, we should not be afraid of using frozen embryos instead of fresh embryos because nowadays, success rates in terms of pregnancies are pretty much the same.

Thanks to vitrification, the technique that we nowadays use to freeze the embryos, the survival rate of the embryos (when you are working in a good lab and a good clinic) is usually more than 95-98%. It means that most of the embryos make it to the thawing process. Obviously, the criteria that are used to decide, which embryos are worth being frozen, are very strict. It maximizes the chances that those embryos can survive the thawing process and give a pregnancy.

Answer from: Marisa Lacácer García, MD

Gynaecologist, Obstetrician, Director and Head of the Assisted Reproduction Unit Eva Fertility Clinics
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Some years ago, vitrification did not exist, and the way of freezing embryos was very slow and harmful to the embryos. When we thawed them, their quality was lost or decreased. That’s why a few years ago, it was better to do a fresh embryo transfer rather than a frozen one.

Nowadays, with the vitrification process, things have changed. Vitrification is a fast method of freezing the embryos that maintain their quality. So when we refreeze the embryos, they are the same as if they were fresh. Thanks to vitrification, we can now transfer either fresh or frozen embryos – with the same success rates.

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About this question:

Undergoing IVF, is fresh or frozen embryo transfer better?

Frozen embryo transfer is the process of using cryopreserved embryos, which have been thawed within the IVF process and next transferred. Do statistics support any option?

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