Frozen embryos just as effective as fresh alternative in IVF treatment

Frozen embryos

Frozen embryos as good as fresh ones in IVF pregnancies

Until 2012 or so, the majority of clinics in North America favoured fresh embryo transfer.

Previous research by this team found that women with polycystic ovarian syndrome - abnormal ovulation - fared better with frozen embryos.

Researchers studied 800 women who had infertility not related to polycystic ovarian syndrome (PCOS).

He added, "Now these two papers, equally large and done in non-PCOS patients, show that in terms of live birth, which is what we care about, there is no difference".

Many women struggling to have a baby turn to in-vitro fertilization to improve their chances, and then face further uncertainty and anxiety when confronted with the decision of whether to use frozen or fresh embryos. Notably, women randomized to receive frozen-embryo transfer had lower rates of ovarian hyperstimulation syndrome compared to women who received fresh-embryo transfers.

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Freezing embryos also allows couples to take advantage of genetic testing, which can pick up potentially lethal genetic diseases and guide doctors in deciding which embryos to implant.

Chen and colleagues noted, however, that "caution is warranted in the interpretation of this finding because the analysis was post-hoc and the overall rates of pregnancy loss did not differ significantly between the two groups".

The shift to frozen embryos was triggered by a landmark study in the field published in 2012, which found that frozen embryos actually were more likely to successfully implant in the uterus when transferred than fresh embryos - and theoretically more likely to result in a full-term pregnancy and live birth.

Dr. Lan Vuong, of the University of Medicine and Pharmacy at Ho Chi Minh City and lead author of the Vietnamese study, said that in the past, doctors often implanted several fresh embryos because of concerns that frozen implantation may not be as effective.

Rates of ongoing pregnancy occurred in 36 per cent of the frozen-embryo group and 34.5 per cent in the fresh-embryo group, according to the study.

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Co-author Ben Mol, Professor of Obstetrics and Gynaecology at the University of Adelaide's Robinson Research Institute, said the study was done after the development of a "quick-freeze" vitrification method in recent years resulted in an increased uptake of frozen-embryo transfers. All women had regular menses and were undergoing their first cycle of IVF or intracytoplasmic sperm injection because of tubal factors, male factors, or both.

The second benefit (which is still being debated in the scientific community) is that having a more "normal" estrogen level at the time of embryo transfer may result in a healthier pregnancy. This could challenge the long-held belief of fertility specialists that freezing and thawing embryos before implanting them offers a better chance of successful pregnancy and birth.

"They only looked at day-three embryos, whereas the general practice in Australia today is day-five transfers", he said.

There were no significant differences in the live-birth rate between the frozen-embryo group and the fresh-embryo group (48.7% and 50.2%, respectively; relative risk, 0.97; 95% confidence interval, 0.89 to 1.06; p = 0.50).

"Health systems in other countries make it more possible to do proper randomised control trials, so it's excellent that we are getting those relationships built up", Chapman said.

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