GHOST - FET vs Fresh

[Mellie_1233]

I notice that clinics have higher success rates with fresh cycles than frozen. How much of this difference is due to the frozen embryos being the ones that "didn't make the cut" for the first transfer? And, how much is due to the freezing process itself?

In other words, if you did a cycle where you froze all the embryos and then went back later and thawed and transfered them does that decrease your odds of establishing a pregnancy (compared w/the traditional method of a fresh transfer).

[Ghost]

I notice that clinics have higher success rates with fresh cycles than frozen. How much of this difference is due to the frozen embryos being the ones that "didn't make the cut" for the first transfer? And, how much is due to the freezing process itself?

In other words, if you did a cycle where you froze all the embryos and then went back later and thawed and transfered them does that decrease your odds of establishing a pregnancy (compared w/the traditional method of a fresh transfer).

Hard to say what the exact proportions are, but when we freeze the entire cohort, then thaw and transfer just the best, we get better success rates than with fresh embryos. Much better, actually.

[lynniecat]

Wow, much better! That is amazing! Ghost are you allowed to tell us what clinic you work at???

[Mellie_1233]

I'm not sure I understand. You mean that a frozen cohort that is later thawed will result in a BETTER pregnancy rate than a FRESH transfer? If so, why don't we always freeze and transfer on another cycle?

(I go to CCRM if that makes a difference.)

I'm so surprised, I just want to make sure I'm getting this right.

Thanks for the response!

[Ghost]

Wow, much better! That is amazing! Ghost are you allowed to tell us what clinic you work at???

I suppose I'm allowed, but I never do.

[Ghost]

I'm not sure I understand. You mean that a frozen cohort that is later thawed will result in a BETTER pregnancy rate than a FRESH transfer? If so, why don't we always freeze and transfer on another cycle?

(I go to CCRM if that makes a difference.)

I'm so surprised, I just want to make sure I'm getting this right.

Thanks for the response!

CCRM has a recent news report where they claim "80% pregnancy rates" with frozen embryos after some genetic testing. We can match that (a little better, actually) and we don't bother with any genetic testing. Nor do we screen patients. Nothing fancy at all, no scientific breakthroughs, just doing what makes sense.

It may seem hard to believe, but it's true. I assure you we are not the only ones to be figuring this out and in the coming years the pregnancy rates with frozens are going to jump. One doctor I talked to claims he will be getting a 70% live birth rate with frozens. He said nobody would believe it. I told him I believe it, because we are getting about the same. The national average is just over 30% in the youngest age group, by the way, so yes, this is a big change.

[Melo_P]

Wow!!! Is there any medical journal or other information you could direct me too to support these findings? I am about to embark on another round of IVF and am hugely interested in these findings.

Funnily enough for myself and several others we all had success in the FET over the Fresh - although this higher success rate is not supported in the clinic stats. (With Fresh still much higher overall - perhaps partially due to fact then that fresh cycles tend to always be preferred route and use up the best quality embbies.)

I wonder why? Is it the lack of drugs? Or are the frozens at your center medicated cycles also.

I don't think I would forgo the fresh cycle but this would definitely make me reconsider how many I transferred at fresh or whether I would choose to freeze all but one.

Those results are incredible.

thanks

Mel

[Ghost]

Wow!!! Is there any medical journal or other information you could direct me too to support these findings? I am about to embark on another round of IVF and am hugely interested in these findings.

The results of 2008 will not hit the journals until 2009-2011. Publishing takes a long time. Gather enough data (100+ cycles) to be convincing, search the literature, write it up, get it reviewed, revised, and accepted, then printed. The last step alone, from acceptance to print, takes one year in the journal most often used for IVF results.

SART reports for 2008 will not be available until 2010.

Still, there are some clinics with FET pregnancy rates like I'm talking about. Here's one:

https://www.sartcorsonline.com/rptCSR_P ... cPKID=2178

I have no affiliation with that clinic.

But notice the 80.8% live birth rate with FET in the youngest age group. It can be done. We are not reaching 80% live birth yet, closer to 70% with these all-freeze cycles, but we are easily beating the fresh cycles.

Funnily enough for myself and several others we all had success in the FET over the Fresh - although this higher success rate is not supported in the clinic stats. (With Fresh still much higher overall - perhaps partially due to fact then that fresh cycles tend to always be preferred route and use up the best quality embbies.)

I wonder why? Is it the lack of drugs? Or are the frozens at your center medicated cycles also.

It's the lack of ovarian stimulation. Ovarian stimulation affects endometrial receptivity. Receptivity is better in FET and donor cycles. So many keep focusing only on the embryos. The endometrium is half of the problem!

[lynniecat]

So that would suggest that if you have a lot of good looking eggs you SHOULD freeze them and put them back later?

So what is causing this leap in numbers? Changes to the freezing/thawing or changes to preparing the recipient?

[Ghost]

So that would suggest that if you have a lot of good looking eggs you SHOULD freeze them and put them back later?

So what is causing this leap in numbers? Changes to the freezing/thawing or changes to preparing the recipient?

The leap from fresh or the leap from the old frozen methods?

The leap from fresh is because of the better endometrium.

The leap from other frozen embryo methods is because of the use of primary embryos instead of second-best. It also helps if they are given more time after thaw to make sure they really survived and are developing.

[toobee]

I am amazed by this info- Makes me think I should have done FET, but to late, I just hat ET today. I m surprised by this info

[NY4thtry]

Ghost

these statistics are amazing.. is this also true for women over 40 i have asked both my Dr at Cornell and Dr Gleicher of CHR and they bth said they would not do frozen..

I really wish you would tell us your clinic....

[lynniecat]

Wow, I hope I have enough to freeze, but more importantly I just hope for some good quality embryos!

[Ghost]

Ghost

these statistics are amazing.. is this also true for women over 40 i have asked both my Dr at Cornell and Dr Gleicher of CHR and they bth said they would not do frozen..

I understand and expect that reaction.

I think they may change that tune within 5 years. We shall see.

I really wish you would tell us your clinic....

I've never used this website to steer even one patient to my clinic (although it is tempting when I see a heartbreaking failure that I think we could help). I consider it unethical to use friendly, open medical discussion for business purposes.

[bey1214]

hi there.. I've been reading this entire post and i really find it so interesting. I am scheduled for a FET next week sometime... and i'm so excited. Ghost I looked at the link you gave (see below )
Thawed Embryos From Non-Donor Oocytes <35 35-37 38-40 41-42
Number of transfers 26 7 7 2
Percentage of transfers resulting in live births 80.8 4 / 7 2 / 7 1 / 2
Average number of embryos transferred 2.1 2.9 2.9 3.5

my question is under the age group of 35-37 it only gives a 4/7 -- it doesnt give a percentage like the first age group does..what does that mean?
thank you so much for responding.