Fresh vs. Frozen Embryo Transfer: Which IVF Option is Best for You?

Grace Fertility

Authored & Verified by:

Dr. Reubina Singh

MS (OB/GYN), MBBS - Senior Infertility Specialist

In the context of IVF treatment, the decision to undergo a fresh embryo transfer or a frozen embryo transfer is a significant one that can impact success rates as well as health outcomes. Both route options have their unique benefits, but the best choice will ultimately depend on your own health, fertility challenge, and goals. We will help you make sense of this by breaking down each option in simple terms, discussing the process, pros and cons, and considerations to help you know what may be a good fit for your fertility journey.

What Is a Fresh Embryo Transfer?

In a fresh cycle of embryo transfer, the whole process of IVF—egg retrieval, fertilization, embryo transfer—takes place within a single menstrual cycle. After eggs are retrieved and fertilized, all resulting embryos are transferred straight to the uterus only days later, with no freezing or delay.

Pros of Fresh Embryo Transfer

Less Time Involved: As the embryo is transferred during the same cycle, the IVF process is quicker than traditional IVF, hence, it’s attractive for patients who want to move forward without any delay.
Potential for Reduced Costs: Without the need to freeze and thaw embryos, fresh transfers could lower some of the costs associated with storage.

Cons of Fresh Embryo Transfer

Multiple Hormone Release: In order to stimulate the production of eggs, women are given doses of hormones through injections. Those elevated levels have an impact on the uterine environment, which may lower the success rates for pregnancy.
Not Suitable for PCOS Women: Women suffering from Polycystic Ovary Syndrome (PCOS) tend to produce a higher number of eggs, due to increased levels of hormones, which could complicate their pregnancy—this is why they are not ideally suited for fresh transfer.

What Is Frozen Embryo Transfer?

The Frozen Transfer Cycle (FET cycle) is where an embryo is created, then frozen until another cycle later on down the line with the body hormonally balanced and ready to receive the embryo. In a later cycle from the egg retrieval and fertilization steps, the embryo is thawed, if needed, and inserted into the uterus.

Advantages of Frozen Embryo Transfer

Higher Rates of Success: Evidence shows that frozen embryo transfers result in higher success rates based on studies. This is due to the fact that the body (hormones) is in a more natural state when the embryo is transferred, thus creating a better environment for implanting.
Preferred in High-Hormone Conditions: The frozen cycle would be preferred in conditions like PCOS or for high-quality embryos to prevent overstimulation and improve the chances of a healthy pregnancy.
Flexibility: Because embryos are cryopreserved, you have the option to transfer at a time that you determine is appropriate, providing your body with adequate time to recover from the stimulatory phase of IVF.

Disadvantages of Frozen Embryo Transfer

Added Time and Expense: Frozen embryo transfers may incur additional time and expenses for embryo storage since the embryos must be frozen and thawed later.
Risk of Embryo Loss: While the occurrence is rare, there is some risk of embryo loss during freezing and thawing. That said, technology has come a long way in minimizing this risk.

Why Would You Want a Fresh Embryo Transfer?

Frozen embryo transfers are growing ever more frequent and advantageous for medical reasons, but in special circumstances a fresh embryo transfer may be preferable:

Low Egg Count: If a woman produces fewer eggs, immediately transferring an embryo can sometimes give her the best chance for pregnancy without the risk of the embryo being lost when it’s frozen and thawed.
Normal Hormone Levels: When hormone levels are maintained and not affected by stimulation, a fresh transfer has the same success as that of a frozen.
Less Health Complications: For those who don’t have any underlying conditions like PCOS or any other high-hormone conditions, fresh transfer can be a good option.

When to Use Frozen Embryo Transfer?

There are indications for frozen embryo transfer which is commonly preferred:

PCOS or High Egg Count: PCOS patients or patients with a high egg count often have increased hormone levels post-stimulation. In these circumstances, a frozen transfer is much safer and less likely to cause complications, such as OHSS.
Increased Chances of Success: It can lead to higher success rates since the hormones are controlled more due to the natural processes used to prepare for FET.
Flexibility for Future Pregnancy Planning: If you freeze embryos, you have the option to plan when to carry your pregnancy, which can provide important consideration for people with high-demand schedules or those who want to wait for better health conditions before trying for pregnancy.

Fresh vs. Frozen Embryo Success Rates

In general, frozen embryo transfers tend to have marginally higher rates of pregnancy than fresh transfers. This is mostly attributed to the natural levels of hormones the uterus is exposed to during frozen transfers, which provides a more stable and welcoming environment for embryo implantation.

The success rate will vary for each individual based on specific health factors, but selecting the correct option in collaboration with a fertility specialist can still greatly heighten your chances.

Q&A About Fresh and Frozen Embryo Transfer

What Is Cheaper? The immediate costs for a fresh transfer may be a little less since it does not have the storage and freezing fees. But costs vary for many reasons, and a clinic can give you a personalized estimate.

How Long Can Embryos Be Frozen For? Frozen embryos are able to remain viable for many years (typically five to ten years but can be extended) with correct storage. “Frozen embryos actually maintain their quality quite well, so you have the luxury of waiting until the timing is best for you.”

Is It Safer to Freeze Embryos? Depending on freezing methods, modern freezing techniques (e.g., vitrification) significantly decrease potential genetic damage during freezing. The risk of losing or damaging the embryo is now very low, and frozen embryos have the same success rates as fresh ones.

Can I Decide Between Fresh or Frozen Transfer? Which one you choose depends on your health, hormone levels, and fertility goals. Many clinics will advocate for frozen transfers because of their high success rates, but you can make the right call for your individual situation by consulting with your fertility physician.

Conclusion: Which Option Is Best for You?

Frozen vs. Fresh Embryology is extremely subjective to each case, as there are benefits to both types of transfer. Fresh transfers are usually faster and involve fewer initial expenses, but they’re best for women who have stable hormones and fewer eggs. However, frozen transfers allow for flexibility, boast higher success rates, and are recommended in cases such as patients with PCOS or elevated hormone levels.

Both can lead to successful pregnancies, and your fertility specialist will collaborate with you to decide which option best suits your health needs and fertility goals. Learning about these options can help you make more informed decisions on your journey through IVF.ssroads, know that guidance, support, and advanced fertility techniques exist. With the right team around you, you can start taking steps toward one day realizing your dream of starting a family.