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Feeling overwhelmed about choosing between fresh versus frozen embryo transfer? You’re not alone. It’s a big decision on your IVF journey, and we’re here to help you understand the options.
The good news is that fresh and frozen embryo transfers have similar success rates. A huge relief, right? It means you have options—but some key differences might make one a better fit for you than the other.
Fresh embryo transfer helps women with low or moderate responses to ovarian stimulation. This choice has a shorter pregnancy time. Plus, fresh embryo transfer is better for your bank account.
Frozen embryo transfer may be a better choice for “high responders,” those who produce a large number of eggs during ovarian stimulation. And it’s the better choice for women with ovarian hyperstimulation syndrome (OHSS), PC56OS, or endometriosis.
So, what exactly is an embryo transfer anyway? And what are some other ways fresh vs. frozen transfers stack up? We’ll get into all the details so you can figure out which option is right for you.
Takeaways
- An embryo transfer is part of the IVF process—where one or more embryos are placed into the uterus using a catheter. The two options for embryo transfer are fresh and frozen.
- In a fresh transfer, the embryos are typically transferred to the uterus within a few days of egg retrieval and fertilization.
- In a frozen transfer, the embryos are frozen through cryopreservation and stored safely in a cryobank. They are thawed and transferred to the uterus during a later IVF cycle.
- Fresh and frozen embryo transfers have similar success rates.
- Fresh embryo transfers are often preferred due to the lower cost and shorter time to pregnancy.
- Frozen embryo transfers might be a better choice for women with certain health conditions, if preimplantation genetic testing is desired, or when there are concerns about uterine receptivity from ovarian stimulation.
- Talk with your fertility specialist or healthcare provider for personalized advice.
What is embryo transfer?
Embryo transfer is part of the multi-step in vitro fertilization (IVF) process that helps people and couples become parents. IVF starts with you taking medications to stimulate your egg production (helping your body release more eggs than usual).
After that, your eggs are collected during a quick procedure and shipped off to the lab. Those precious eggs are then fertilized with sperm, and they keep a close eye on the little embryos during their growth.
And finally, it’s time for the embryo transfer—where they gently place one or more of those embryos into your uterus using a catheter. The whole process is quick and painless, and there’s no need for anesthesia.
What are fresh and frozen embryo transfers?
Once your embryos are collected, it’s decision time: fresh transfer vs. frozen transfer. This decision marks an exciting step in your IVF journey—getting that much closer to a positive pregnancy test. But it can also be a super confusing time. Let’s take a look at what fresh vs frozen embryo transfers involve:
Fresh embryo transfer
Think of this choice as the express route on your path to parenthood. Fresh embryo transfer is all part of the same IVF cycle. Just three to five days after egg retrieval, the embryo is transferred into your uterus. It’s like a streamlined process—all the steps in one go. This means less waiting time and a potentially quicker path to pregnancy.
Frozen embryo transfer
The same steps apply here: you take meds to stimulate ovulation, retrieve those eggs, and then fertilize them in a lab. But this time, instead of transferring the embryos right away, they’re saved for later using a process called cryopreservation. Your healthy embryos are stored safely at a cryobank for future use during another IVF cycle. When you’re ready, those little embryos are thawed and transferred at a later date.
Frozen embryo transfer also has two types of cycles—natural or medicated.
With a natural cycle, the transfer is timed based on when you ovulate naturally. During a medicated cycle, your body gets a little extra support. You get some medications to mimic your body’s natural cycle. These drugs thicken your uterine lining, or endometrium, to prepare for implantation.
Sometimes, a frozen embryo transfer is the better option. IVF drugs can spike your hormone levels, and this can move the “window of receptivity” (aka the time when the uterus is most receptive to receiving the embryo) earlier. Basically, your uterus thinks you’re already pregnant and rushes to get ready for an embryo. So, if you’re doing a fresh cycle, by the time the embryo is ready, your uterus is less likely to be “receptive,” lowering the chances of a successful embryo implantation. A frozen embryo transfer lets your fertility provider wait until your body is really ready so the embryo has a better chance of implanting.
Success rates
Let’s get to what everyone wants to know: which is better, fresh vs frozen embryo transfer?
Good news! Both fresh and frozen embryo transfers have similar pregnancy success rates, giving you the power of choice during the IVF process. When deciding between a fresh or frozen embryo transfer, several factors come into play: Your age (or your donor’s age), sperm and embryo quality, and your overall health during both types of transfers.
Purpose of the study | Findings | |
To find out if a ‘freeze-all’ IVF approach results in higher pregnancy rates and fewer complications than fresh embryo transfers. | There were no big differences in live birth rates or pregnancy outcomes between fresh versus frozen embryo transfers. | |
To find out if live birth rates increase in frozen embryo transfers among women with infertility. | They found no major difference in live birth rates between fresh and frozen embryo transfers. But frozen embryo transfers resulted in a lower risk of ovarian hyperstimulation syndrome. | |
To compare the benefits of elective fresh versus frozen single embryo transfers. | There were no differences between single embryo transfers. | |
To compare IVF and pregnancy success rates when a first fresh embryo transfer is followed by a first frozen embryo transfer. | Frozen embryo transfers were more beneficial for high responders versus intermediate or low responders. | |
To compare the overall success rates of fertility treatments using fresh embryos versus frozen embryos in women with infertility caused by endometriosis. | For women with endometriosis struggling with infertility, frozen embryo transfers in a later IVF cycle had a much higher success rate—43% compared to 29.6% for fresh embryo transfers. | |
To find out if frozen embryo transfers have better pregnancy outcomes and lower chances of OHSS and other pregnancy complications for women with PCOS. | Women with PCOS experienced better success rates and a reduced risk of OHSS with frozen embryo transfers. | |
To explore the safety and effectiveness of ‘freeze all’ embryo transfers compared to traditional fresh embryo transfers. | Both the traditional IVF approach and the ‘freeze-all’ approach had similar overall success rates. 58 out of 100 fresh embryo transfers resulted in live births, compared to between 57 and 63 out of 100 for the ‘freeze-all’ approach. The ‘freeze-all’ method seemed to lower the risk of OHSS. |
Advantages and disadvantages
We know that both fresh and frozen embryo transfers have similar success rates. But each comes with its own pros and cons, and there are some key differences to consider.
Fresh embryo transfer | Frozen embryo transfer | |
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Disadvantages |
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Cost
If you’ve done your IVF homework, you know the procedure can be a significant financial investment. When it comes to the cost of fresh versus frozen embryo transfers, there are some key differences to keep in mind. Let’s break it down:
The cost of choosing a fresh embryo transfer ranges from $20,000 to $25,000. This price generally includes the entire IVF process—medications for ovarian stimulation, the egg retrieval procedure, all the necessary lab work, and the embryo transfer itself.
Since frozen embryo transfers involve some additional steps, there are some added costs. Embryo cryopreservation (the process of freezing the embryos) typically adds $1,000 to $2,000 to the overall cost. Once frozen, those embryos need to be stored in a specialized facility, which usually costs around $350 to $600 per year.
On the plus side, opting for a frozen embryo transfer often means lower medication costs, typically ranging from $300 to $1,500. Frozen transfers also give you the genetic testing option to screen for potential abnormalities, which can cost anywhere from $1,800 to $6,000.
Keep in mind that these price ranges are estimates. It’s always a good idea to connect with your fertility clinic early on to discuss your options and get a personalized quote. Your location and individual circumstances can also influence the final cost of IVF.
Most insurance plans don’t cover cryopreservation or frozen embryo transfer costs. But, some clinics offer financing, payment plans, or discounts to make your treatment more affordable.
When to choose fresh vs. frozen embryo transfer?
Now that you have the info, it’s time to decide. When do you choose fresh or frozen embryo transfers? Here’s a quick rundown of when each option might be the better choice:
Fresh embryo transfer | Frozen embryo transfer |
You want a shorter time to pregnancy | You’re not ready to get pregnant immediately |
You want the less expensive option | You’re a high responder, or you have a condition that increases your risk of ovarian hyperstimulation (like PCOS or endometriosis) |
You’re a low or intermediate responder | You want genetic testing done |
There is no one-size-fits-all approach to choosing between fresh versus frozen embryo transfers. Each option provides specific benefits for different women, and every circumstance is different.
Talk to your support system and fertility provider. Discuss the options and make the best choice for your family. No matter the route, the outcome is the same: a healthy pregnancy and baby. You’ll get to enjoy all the joys of parenthood.
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- Transfer of thawed frozen embryo versus fresh embryo to improve the healthy baby rate in women undergoing IVF: the E-Freeze RCT – PMC
- Transfer of Fresh versus Frozen Embryos in Ovulatory Women | New England Journal of Medicine
- Fresh vs. frozen embryo transfer: new approach to minimize the limitations of using national surveillance data for clinical research – ScienceDirect
- Impact of in vitro fertilization state mandates for third party insurance coverage in the United States: a review and critical assessment – PMC
- Freezing of all embryos in in vitro fertilization is beneficial in high responders, but not intermediate and low responders
- Fresh versus frozen embryo transfers in assisted reproduction – PMC
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