Thursday, November 19, 2015

Fresh Vs Frozen Embryos




“Dr, should I opt for frozen embryos or are fresh ones better?” This is a very common question I get to hear from patients who have come in for a consultation. If I had to answer this question a few years ago, I would have unhesitatingly said that fresh embryos are definitely better compared to frozen ones- it’s what conventional medical teaching says. That’s because in the past, when we used the slow freezing technique, a lot of embryos would get damaged during the thawing process, as a result of which fresh  embryos used to have a higher implantation rate (meaning they have a much better chance of actually turning into a baby).

But we don’t live in that time and things are very different from what they were then. In a standard IVF cycle, we superovulate the patient. The downside to this process is that these very hormones that help a patient produce more eggs also mess up her uterine lining; this impacts its ability to be receptive for implantation. It’s one of the reasons why natural cycle IVF and mini IVF are a more popular choice today.

Studies indicate that when you compare the implantation rates of embryos in natural cycles vs superovulated cycles ( using embryos of the same quality), the implantation rates of the former are higher than the latter. This goes to show that patients may actually have higher chances of getting pregnant when transferring frozen embryos in a natural cycle.  This helps keep the lining of the uterus at its optimal receptivity , so that it can allow embryo implantation more effectively.

The Vitrification Process

Earlier, the slow freezing protocol was the only one available for freezing embryos. This wasn’t too efficient and there were very high chances of damage to the embryos during the freezing and thawing process. Even in the best of IVF labs, the embryo survival rates were dismal; this was primarily because the slow freezing process itself caused damage to the embryo. Ice crystals formed within the cells , and damaged the blastomeres. Unfortunately, the damage couldn’t be prevented even with the cryoprotectant chemicals used in the process.

But vitrification came along and changed all that. With this process, we get more than 99% survival rates; in addition, we are also certain that the blastomeres won’t perish when they are thawed.  Of course, it’s vital that this process be handled by a skilled embryologist. This is a significant advance in the field which as completely transformed IVF.


Why Use Frozen Embryos?

One of the major advantages is that we don’t have to now transfer too many embryos in a single cycle.  We have the technology to freeze embryos for our patients and this gives them the peace of mind and assurance that in case they need to use their embryos later, they will find them safe and sound. Today, our patients are more than willing to accept single embryo transfers because:

They aren’t worried or concerned that they are wasting or discarding their precious embryos
The frozen thaw cycle is far easier for patients; it is less disruptive and stressful as and we don’t have to do more than 1-2 scans
They are easier to repeat
Lesser risk of high order multiples
Excellent cumulative conception rates
Much easier on the pocket

Choose the Right Clinic

The one thing that patients should keep in view is that all clinics don’t have the best technology to vitrify embryos. It’s a relatively new technique and only a skilled and experienced embryologist would be able to tackle it well. The vitrification learning curve is very steep and most embryologists end up killing the embryos while they are training to vitrify them.

The only way to ensure your embryos are treated well is to opt for a reputed and experienced clinic that employs a full-time embryologist. It’s also important that the clinic provide you photos of your embryos; prior to vitrification and post thawing.

Not happy with the attention you are getting from your IVF clinic? Need more information? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you!

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