Wednesday, December 18, 2013

Please freeze your embryos

IVF treatment is very effective today and a good IVF clinic will be able to create many embryos for most young patients , because of our ability to superovulate them . In a good lab, most of these embryos are of high quality , and since we don't want to transfer too many embryos at one time, because this increases the risk of a high order multiple pregnancy, the question is -  what do we do with the supernumerary ( spare) high quality embryos ?

We strongly encourage all patients to freeze all their spare good quality embryos, but inspite of this advise, many patients decide to discard their embryos , because freezing embryos costs them extra money. Since this is often a decision they regret later on, let’s look at why they make this choice.

Many patients feel that since the embryos which the doctor is transferring are of such high quality , my chances of getting pregnant are excellent in this cycle itself, so why should I waste money freezing the spare embryos ? The truth is that no matter how  perfect your embryos look, the success rate in an IVF cycle is never 100%; and most embryos do not implant and fail to become babies, no matter how perfect they look, for reasons we still do not clearly understand.  In case the fresh cycle fails, having frozen embryos as a back up plan gives you an excellent chance of conceiving, at a fraction of the cost of a new fresh cycle . Because the new technology for freezing uses vitrification, the survival rates of frozen embryos after thawing is nearly 100% in our clinic !

Some patients believe that freezing embryos will damage them; and that the “ice-babies” which are born from these frozen embryos are likely to be abnormal. This is faulty reasoning. Thousands of babies have been born after embryo freezing, and this has been proven to be a very safe procedure.

Another ( often unvoiced) concern is that if the best quality embryos from this batch ( which the doctor will transfer in the fresh cycle ) do not implant, then doesn’t this mean that  the chances of the other frozen embryos from the same batch implanting are going to be even lower ?

This sounds logical, but the truth is that  the chance of a good quality embryo implanting is independent of the fate of the other embryos from the same batch. Even if you don’t get pregnant in the fresh transfer, the chances of getting pregnant with the frozen embryos remains extremely high . In fact, there are some IVF clinics which do not transfer any embryos at all in the fresh cycle, because they believe that the superovulation distorts the hormonal milieu and reduces endometrial receptivity. The routinely freeze all the embryos; and transfer them only after thawing in a natural cycle, and can boast of a very high pregnancy rate.

What if you do get pregnant in the fresh cycle ? Then won’t you have wasted your precious money on freezing your embryos ? No ! The fact remains that frozen embryos do not have a shelf life; and you can then use these same frozen embryos to have Baby N 2 after a few years, when you want to complete your family. The pregnancy rate with these embryos is likely to be very good – and they have a much better chance of achieving a pregnancy than a fresh cycle ( because your eggs will have aged, but your frozen embryos  will remain young forever, until you thaw them ) Freezing suspends all metabolic activity, so the embryos are frozen in time  ( much like Sleeping Beauty) !

Sadly, a lot of IVF doctors fool their patients by telling them that freezing embryos is of no use. This is because they don't have the facility or expertise for freezing embryos. This is why they then “donate” your spare embryos to other patients, without getting informed consent, either from you or from them. This is tragic , and this is why you need to be sure that your IVF clinic has a robust freezing program which uses vitrification technology.

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