Is Fresh Or Frozen Best For Embryo Transfer During IVF?

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Despite the first-ever baby being born via IVF turning 40 this year, IVF can still feel like a hit or miss field with many more chances for failure than opportunities for producing a new life.

When you’re going through infertility treatments, all you want are answers. You want the facts. You want to know what your chances are for success. You want to know what the drugs are and what they will do to your body. You want to know all the costs involved so you can be prepared. You want to know all the ways to stack the odds in your favor.

However, when it comes to one of the biggest questions most women going through IVF have, science now says there is no one-size fits all answer for IVF patients and embryo transfer.

embryo transfer - The Everyday Mom Life

There’s been a debate in the infertility medical field for years when it comes to using a fresh embryo or a frozen one. The findings of a new study from Duke University Medical Center suggest that it may depend on how many eggs there are to work with.

According to a study published in Fertility and Sterility this month, the best technique may vary and depend on how many eggs the patient produces. The data comes from almost 83,000 first-time IVF patients included in the registry of the Society for Assisted Reproductive Technology between 2014 and 2015.

To make conditions right for a fresh transfer, patients take hormones for several weeks to stimulate egg production. The doctors then retrieve the eggs, fertilize them and place one or more than one in the mother all during the same procedure.

However, many clinics now have been encouraging patients to freeze all their eggs and wait a few weeks for a new cycle to begin.

“In the past five years, some clinics have advocated for freezing everything with the belief that the process that stimulated the eggs makes the lining of the uterus less welcoming for pregnancy,” said Suheil Muasher, M.D., a senior author on the paper and reproductive endocrinology and infertility specialist at Duke.

However, the new Duke study found that waiting to use frozen embryos during embryo transfer may only benefit patients who product 15 or more eggs after hormone stimulation. The birth rates for these patients, so called “high responders”, were 52 percent which is several points higher than those who received fresh transfers at 48 percent.

The study also found that women who produced fewer than 15 eggs after the hormone treatment were more successful in terms of pregnancy and birth rates when they used fresh transfers. Women who produced one to five eggs after the hormone treatment were considered low responders. Intermediate responders produced six to 14 eggs.

Kelly Acharya, M.D., a fellow in reproductive endocrinology and fertility at Duke and the study’s lead author believes there are also other benefits, including emotional benefits, to using fresh embryo transfers.

“From the patient perspective, if they can go ahead and do a fresh transfer it saves them the additional waiting and having to take another cycle of hormones,” she said. “Freezing also can lead to another one or two months of waiting and not knowing whether the procedure will be successful, which can be emotionally draining for patients. From these data (points), it doesn’t look like there is any benefit to waiting.”

The earlier research suggesting to freeze all the embryos had been limited in the number of patients included in the study, Muasher said. He believes this study is a more accurate representation of patients in the United States today but also believe more research is needed. Authors were not able to evaluate the reasons patients decided to use a frozen embryo versus a fresh embryo.

Still, Acharya hopes that the Duke study helps ease the emotional weight for those who may be a low or intermediate responder.

“The bottom line for patients is that they’re likely seeing a lot of information out there saying frozen transfer is best all of the time, and we are seeing that may not be the case,” she said. “Hopefully, this could put some patients’ minds at ease if they are a low or intermediate responder and doing a fresh transfer.”

To read more about the study, click here. For more research and parenting news, click here.


  1. I am thankful that my husband and I have never had to go through this life challenge.
    We have friends and family who have had to though.
    I am so thankful for science and the technology that has come so far.

  2. This was really educational. I wasn’t aware of this study and thought that fresh was always first choice. I know many wonderful children who were IVF babies, and it’s amazing what the advances of science have been able to accomplish – even during our life times.

  3. I am so blessed that I don’t have to go through this. However, for a LONG time – my entire life – I did think this was my reality because I was told I could never have kids! But MIRACULOUSLY… I got pregnant and I am now due in December!

  4. I don’t know much about IVF having never known someone personally who went through it. But it’s really interesting to know there are multiple ways and options. The doctor I used to work for did artificial insemination in the office, but never did the entire IVF process.

  5. There is a lot of great information here. I didn’t know a whole lot about this. It’s nice to be able to learn a bit more. I know someone who could use this read.

  6. A lot of this went over my head, but one thing stuck with me. “egg production”. I’ve read that women are born with all the eggs we’ll ever have. So how can a woman grow more eggs?

    • Your body has more eggs than it will ever need. Women who do IVF are given hormones to help their body mature mutliple eggs. Your body usually only matures one egg per cycle.

  7. This is all great information about IVF. My brother and his wife are discussing this option. I will definitely pass this along.

  8. I have two beautiful rainbow babies from a frozen embryo transfer of 6day blastocysts (typically embryos are allowed to grow in the lab for 3-5 days before they are fresh transferred or frozen for future transfer). I think it’s important to clarify that while you can transfer more than one embryo, most reputable clinics recommend one embryo transfer and two at most, and they are definitely not transferred in the same procedure as retrieval. Even for a fresh transfer the eggs are retrieved and fertilized and then grow in the lab for 3-5 days before transfer back. The mother’s body also has to be at the perfect condition for transfer from a hormonal perspective – I had several canceled fresh/frozen transfers because my hormone levels were too high. It’s a complicated and lengthy process but one I will be forever grateful for!

  9. I think there is a paragraph that is a bit misleading here. “The doctors then retrieve the eggs, fertilize them and place one or more than one in the mother all during the same procedure. “

    A retrieval and transfer are always separate procedures. Even fresh transfers. The difference is that with a fresh transfer the embryos are transferred within the same cycle as the retrieval, usually either 3 days post retrieval or 5 days post retrieval depending on embryo quality. With frozen transfers the embryos are frozen and transferred on a later cycle.

    When we did IVF a few years ago we got lucky and our second frozen embryo transfer was successful. She just turned 2 last month. ?

  10. This is such a nice post and really love reading this. It so interesting and informative I can’t believe how far science works into our lives.

  11. Interesting to know this! I’ve read somewhere that not all IVF will have a successful result. It’s amazing how possible these things are these days.

  12. This is such a great post, especially for those going through IVF! I as no idea about the real difference between fresh or frozen embryos!

  13. Wow, what a great and super informative post. I am thankful that I have not had to go through this but I love the info, I have a friend who will find this so useful.


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