A frozen embryo transfer, or FET, is a kind of IVF treatment where a cryopreserved embryo created in a full IVF cycle is thawed and transferred back to a woman’s uterus. The cryopreserved embryo may be from a woman’s previous conventional IVF cycle, or it may be from a donor embryo. If a donor embryo is being used for the process, the embryo is not genetically related to the woman or her partner. The chance of having embryos available to freeze greatly depends on the age factor. For example, less than 25 percent of women over the age of 40 have blastocyst stage embryos available to freeze, while over 65 percent of cycles in which the woman was 30 years old or younger had embryos available to freeze. This fertility technique is most beneficial to couples coping with infertility, single parents and couples above the age of 35 years.
In this article, we will look at:
Why do we freeze embryos?
What are the benefits of frozen embryo transfer?
What are the success rates of frozen embryo transfer?
What are the risks associated with frozen embryo transfer?
How much does FET costs?
1. Why do we freeze embryos?
The ability to freeze and thaw embryos successfully is one of the greatest advancements in ART (assisted reproductive technology). Many fertility patients who undergo IVF (In vitro Fertilization) reap the added benefits of frozen embryos. Embryo freezing-cryopreservation has been practiced for many years, but earlier techniques were associated with undesirable ice crystal formation. Vitrification, fast-freeze technology or a flash has greatly improved outcomes from cryopreserved embryos. Patients who have used frozen embryos now experience success rates equal to or better than, those from fresh embryo transfer cycles. Frozen embryo transfer eliminates Ovarian Hyperstimulation Syndrome (OHSS), which is a dreaded side effect occurring during ovarian stimulation done for IVF purposes. FET also reduces the risk for the unborn baby as well as a neonate. The chances of having lesser growth during pregnancy or sudden unexplained serious health problems after birth are lesser with FET (Frozen Embryo Transfer).
2. What are the benefits of frozen embryo transfer?
Having frozen embryos gives a woman additional opportunities for success from given egg retrieval. If the fresh transfer is unsuccessful, Frozen embryos may provide the possibility of trying again without having to take ovarian stimulation medication or to have egg retrieval. The development of vitrification technology has led to outstanding outcomes, with an increasing number of patients achieving live birth from a single stimulated cycle.
a) Frozen embryo transfer (FET) is less costly
Following a fresh IVF treatment cycle, subsequent frozen embryo transfer (FET) cycles are less costly for patients. Expenses of both treatment and medication are less than in a fresh cycle. Costs of treatment are reduced since there are fewer monitoring visits, and there is no need for egg retrieval, embryo culture or insemination.
b) FET cycle is easier
FET cycles are easier because patients do not need surgery (the egg retrieval) or anesthesia. At the start of the FET cycle, estrogen injections are used to prepare the uterine lining and are administered only once every three days. FET allows patients to reduce their risk of OHSS (ovarian hyperstimulation syndrome) while maintaining excellent success rates.
OHSS is rarely seen in FET, occurring in less than 1 percent of patients. However, in situations where a physician sees potential warning signs that a woman is at high risk for OHSS (high estrogen levels and follicle numbers, fluid in the pelvis, rapid weight gain), the physician may recommend freezing all available embryos rather than proceeding with a fresh transfer, as pregnancy may increase OHSS risk. Embryo(s) can then safely be transferred via frozen embryo transfer. As with freeze-all cycles for elevated progesterone levels, pregnancy rates remain normal and favorable.
3. What are the success rates of frozen embryo transfer?
Recent studies have provided a great reason for hope when it comes to FET (frozen embryo transfers). A Consensus is that in most cases, frozen embryo transfer (FET) success rates are at least as high as fresh embryo transfer success rates. FET success rates can actually be much higher than fresh embryo transfers for some women. A study published earlier this year found that in women over 35 with high progesterone levels, frozen embryo transfers were 73% more likely to result in an ongoing pregnancy than a fresh transfer. The evidence is building in favor of FET for specific patient populations, with very exciting implications for how they make decisions about embryo transfers. As always, one must keep in mind that each patient is unique, with countless individual factors, which can contribute to her likelihood of getting pregnant from each embryo, transfer, fresh or frozen. Whether a woman is considering a “freeze all” cycle or just wants to know about preserving leftover embryos from a fresh cycle, seek the doctor’s advice to make a plan with the best chance of success for a particular situation.
4. What are the risks associated with a frozen embryo transfer?
A frozen embryo transfer cycle has significantly lesser risks than a full IVF cycle. One does need not to worry about OHSS in a FET cycle since ovarian stimulating drugs are not used. Depending on the number of transferred embryos, there is a risk of multiple pregnancies. Even twin pregnancies come with an increased risk to both the mother and baby. Frozen embryo transfer comes with a slightly increased risk of ectopic pregnancy and there is also a very small risk of infection. With cryopreservation, some embryos may not survive the thaw and freezing process. With elective frozen embryo transfer, there is a possibility of losing embryos that would have been available if done as a fresh transfer.
One study found that pregnancies and babies from frozen embryo transfers may, in fact, be healthier than those from fresh embryo transfers. Another study compared the risks of a particular kind of birth defect in frozen embryo transfers, fresh IVF transfers, and naturally conceived children. The study found that children were three times more likely to have birth defects with fresh IVF transfers when compared to naturally conceived children. However, that increased risk was not seen with frozen embryo transfer. However, there is a possible increased risk of babies being born large for gestational age from frozen embryo transfers.
Frozen embryo transfer babies were at:
Lower risk of stillbirth
Lower risk of preterm birth
Lower risk for low birth weight
Costs of Frozen Embryo Transfer
5. How much does FET Cost?
The cost of FET (Frozen Embryo Transfer) falls between Rs.27930.0 and Rs.76807.5. However, the storage fees may vary from one center to another depending on the storage facility, and the location. The cost of FET can also vary greatly depending on the location. Because of the vast differences in costs, some couples prefer to travel to other cities with more affordable FET treatment plans.
Embryo freezing has many potential benefits. Using the latest technology and techniques performed by board-certified embryologists and expert lab technicians, embryos are instantly flash-frozen and can be safely stored for up to a decade with no loss in quality. Having frozen embryos in the storage means that when the patient is ready for the treatment they can skip the arduous first half of the IVF process and go straight to the embryo transfer procedure. When they have been through so much in their quest to have a baby, having this option available for the next time around is priceless.
SOURCES AND REFERENCES:
Case of the imported embryo Indianexpress.com, 11 April 2019
Comparing pregnancy outcomes using an endometrial receptivity array (ERA) prior to frozen embryo transfer Mdlinx.com, 11 April 2019
Neonatal and maternal outcome after frozen embryo transfer: Increased risks in programmed cycles Mdlinx.com, 11 April 2019
Why Do IVF Pregnancies With Frozen Embryos Raise Preeclampsia Risk? Consumer.healthday.com, 11 April 2019
Freeze all policy for embryos not always best for IVF Bionews.org.uk, 11 April 2019
Frozen embryo transfer versus fresh embryo transfer Medicalxpress.com, 11 April 2019
Frozen embryos more successful for conceiving during IVF Medicalxpress.com, 11 April 2019
Failure of embryo implantation in In-vitro fertilisation Punchng.com, 11 April 2019
Frozen-embryo transfer associated with higher live birth in women with PCOS 2minutemedicine.com, 11 April 2019
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