Fresh or frozen embryo transfer? Pros and cons

[Sara279]

Hi everyone, I’m doing three cycles of embryo banking. Aged 41. Haven’t ever been told I have a problem with my hormone levels and/or endometrium thickness. I wondered what are the pros and cons of fresh v frozen transfer.

If I had a good quality blastocyst on my last cycle, is it worth doing a fresh transfer or freezing them all and waiting a month and then doing a transfer? My consultant suggested the latter, but I have to admit, I’m sick of the drugs and also impatient.

Obviously I just want the best possible chance.

Do any of you have any words of wisdom? Thanks xxx

Hi @Sara279 I just saw your post and I'm in the same position. I was initially going for 3 cycles but need to stick with 1 for now and assess whether to freeze any successful embryo and give the body a rest after stims or take the plunge and transfer after egg collection.

Did you get any further in your thinking?
It seems a rest seems a good approach for the body after stims but I'm the same on wanting to go for it after collection - eeks.

Hi @Hopefuleggs well the decision was made for me as my TSH is raised so my consultant doesn’t want to do a fresh transfer now. We’re not sure we’ll get embryos this time because we’ve only got 4 follicles in the race so it’s a very small chance. How did your cycle go? Xx

I hear you on low follicles. Looks like I have 5 in one ovary and zilcho in the other. So day 2 of stims and we'll see how those follicles go for scan on Friday. I hear its an ever changing process so we can only take it a day at a time and do what we can to stay relaxed and positive 😌 what stage are you at now? X

Why did your consultant recommend a freeze all cycle @Sara279? We were offered the option and I've decided to do fresh, frozen, fresh, frozen (we will do 4 cycles in total) because I wanted to do the egg collections sooner rather than later so ate doesn't become too much of an issue (I turn 38 this summer)

My consultant also suggested this after my final round of embryo banking - it really depends on your drug regime - I was on natural modified IVF so low dose drugs anyway and so we just dropped the tamoxifen as tended to make my lining too thick. If I had been in high dose stims I probably would have took the month off and done a FET

@FingersXssd83 because my TSH is 5.7 and they like it below 2.5. Raised TSH can increase risk of miscarriage x

Hi @Hopefuleggs

I did my first cycle last year aged 41. Two blasts (from 12 eggs), fresh transfer of a 5AA (BFN) and a 4BB into the freezer. I wasn't setting out to bank, but I didn't want to do an FET of my only remaining blast and if it failed then be 42, so I did another fresh round. This time I got 18 eggs (big surprise) and five blasts, but had to have a freeze-all because of the OHSS risk.

I just had an FET last week, a 5AA again, and I'm in the TWW so can't tell you whether it will be successful (wish I knew!). But, I've been told that age and therefore egg quality will be the most significant factor in whether it works, far more so than fresh vs. FET.

I did a natural FET so no drugs, just tracked ovulation and started progesterone a few days before transfer. You could maybe do the same if you have regular cycles. It's definitely easier on your body in that way, but I found the wait between the EC and FET really frustrating and hard. I'd not been expecting a freeze-all and it felt like everything got put back into limbo again. Might be different if it's a choice, though.

@lucymills1234 how long did you have to wait after egg collection for FET? I'm disappointed I have to wait because of my thyroid levels being missed by my clinic. We only know my TSH is raised because I checked them myself x

I ended up a frozen transfer due to fluid in my lining when stimming. My clinic advised me that they have really good results from frozen transfers right now as it gives the body time to recover from the stims process and puts it in a good condition for transfer.
Must have worked for us as got my BFP and I'm 5 weeks today after FET on the 20th!

After egg collection I had to wait for withdrawal bleed from that (about 5 days after EC) and then had to wait for my next natural bleed. On the natural bleed I then started progynova, then mid way through was scanned and put on cyclogest for 5 days then transfer :)

Hi @Moonstarsun same as above - for me it was a withdrawal bleed after EC and then a natural bleed (which was a little later than normal - and that's apparently standard after IVF). If you take the start of the natural bleed as day 1, I started ovulation tracking from day 10 (no meds) and FET was on day 19. I only had cyclogest from the Tuesday, transfer on the Friday.

All in all, it was just short of two months from EC to transfer, but felt like longer!

@lucymills1234 thanks for this information. How far into 2ww are you? Oh god the torture of not peeking... everything crossed for you. Natural FET sounds positive! Will look into this

@willithappen eeeks!! 5 weeks today! Hip hip hooray! Such good news. Are you doing anything different vitamins wise post positive result?

@Hopefuleggs My transfer was Friday so I'm 6 days into the wait... it's definitely dragging. I swerve between having no hope and telling myself to be positive. Torture is the right word.

Natural FET is the default for my clinic so long as you have regular cycles and no issues with lining (mine was 13mm when I went in for a scan the day my ovulation LH surge was positive). I think they're able to offer it because they will scan/transfer any day of the week where clinics that don't often medicate so they can control timings.

@Hopefuleggs I have just moved from the pregnacare preconception onto the pregnancy ones :)
Still on progynova and cyclogest pessaries too. Have to take them until 12 completed weeks of pregnancy

I had a FET because of OHSS. It worked so obviously I'm a fan. My body was a little beaten after EC so I'm sure it was for the best. Not sure if women who don't have OHSS feel like that. I would have had to have progesterone with fresh but I had nothing at all with my FET which suggests they deem the body more naturally capable with a FET.

I waited two months too and it felt like an eternity, but for me it was worth the wait.

Good luck @lucymills1234 🤞

@lucymills1234 8 days now I hope you're doing well. Thinking of you x
@willithappen I hope you are progressing nicely. Absorbing your baby making vibes here

I have my egg collection Monday (risk of early ovulation so they want me in) and im going for 3 cycles now so the pressure is off a little. I'm definitely in the FET camp now after the reading on how egg collection goes. Trigger infection and last cetrotide today eeks (Monday will be cycle 1 complete)

Thanks @Hopefuleggs - feeling a bit queasy the last few days and I'm sure it's pre test day nerves...

Hope your EC goes well tomorrow. Both of mine have been smooth and didn't feel a think during the actual procedure so I'm sure you'll be just fine!

@Hopefuleggs thanks lovely, just a lot of anxiety here. I have had some brown spotting on a couple of days. Currently 5+3 and will get a scan on the 20th May