Wednesday, December 07, 2022

Why you should freeze all your embryos when doing IVF


The reason freeze-all IVF cycles have become so popular is because it increases pregnancy rates , by allowing patients to have their cake and eat it too.

In the past . we would do only fresh cycles and fresh transfers , which means the embryos were transferred back in the same cycle in which the egg collection was done.

The reason for this was that the technology for freezing embryos wasn't very good , and many embryos would die during the freezing and thawing process. Today, however, we are very confident about offering this option routinely to all our patients , thanks to the technology of vitrification or flash freezing , where the survival rate of frozen embryos after thawing is 100% in good labs .

This strategy has lots of advantages .

For one thing, we can transfer only one embryo at a time , because we can store the rest safely. This improves the cumulative conception rate without incurring the risk of a multiple pregnancy , which often ends up as a preterm birth because the uterus wasn’t designed to hold more than one baby at a time !

This means that patients can have as many babies as they want - but one at a time , which is the right way to have babies , because twin pregnancies have a much higher risk of preterm births, and these premature babies often end up with multiple complications ( and also run up a huge bill during their NICU stay).

We can also optimise our superovulation strategy during the fresh cycle, and help the patient to grow many eggs, so we get lots of embryos. Because we are not doing a fresh transfer, the risk of OHSS( ovarian hyperstimulation syndrome, which can be a life-threatening complication) ) is nearly zero, and we can go ahead and freeze all the embryos. This is why, when we do a fresh cycle, our focus is on helping you to grow many eggs. However, the price we pay for this is that endometrial receptivity is compromised,  which is why the pregnancy rate in a fresh cycle is not very good , and this is the reason we prefer not transferring fresh embryos.

On the other hand , when we freeze all the embryos and then transfer them in the next cycle after thawing them one as a time, we can focus only on growing the endometrium in the thaw cycle, so that it’s receptivity is optimal. During this cycle, we don’t need to grow eggs, which is why this thaw cycle is much easier and less expensive, because no injections are needed.

This combined option ( freeze all embryos at the blastocyst stage in the fresh cycle and then thaw them and transfer them one at a time) increases pregnancy rates,  because it allows us to grow lots of embryos, and transferring them one at a time reduces the risk of multiple pregnancies and increases live birth rates. You should ensure that all your embryos are frozen only on Day 5; and that the clinic has a full-time embryologist, who will provide you with photos of your embryos, both before freezing them, and after thawing them

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