In 2009, Shady Grove Fertility tested and ultimately adopted a new freezing method called vitrification. As a result, we immediately began to see our success rates with Frozen Embryo Transfers (FET) rapidly increase.
With the previous technology, FET cycles were a less effective, second tier treatment for couples who were not successful with fresh IVF cycle. However, the latest data shows that now, FETs provide a comparable chance of success to fresh IVF cycles. In 2011, FET cycles outperformed fresh cycles of IVF in terms of their ability to help couples conceive. When you learn how much easier and less costly FET cycles are, the data looks even that much more impressive.
Patients doing In Vitro Fertilization are making a real commitment of time and money to growing their families. They want to know that they’re doing everything they can to maximize their chances of pregnancy from each cycle. That’s why more and more patients are choosing to freeze their remaining, high quality embryos for later use. With Frozen Embryo Transfer (FET), patients can turn one IVF cycle into 2, or even 3, distinct chances at pregnancy.
“There’s really no downside,” says Dr. Naveed Khan of Shady Grove Fertility’s Leesburg office.
“I always stress the benefits of freezing embryos to my IVF patients and almost all of them elect to do it if they have remaining blastocyst embryos.”
Last year, Shady Grove Fertility performed over 1000 FET cycles and this year, we’re on track to do even more. The main reason the program keeps growing is because of its high rate of pregnancy success. Here, Dr. Khan helps us explain FET cycles in detail so that couples heading into IVF won’t miss out on this incredible opportunity.
Saving Embryos for Later
Embryo freezing or cryopreservation is used when a patient undergoing IVF produces more high quality embryos than she wants to transfer during a cycle. Those “extra” embryos are then frozen and stored in the lab for future use. Many patients have multiple embryos to freeze, but the embryos being frozen are of such high quality that it’s worth doing even if there is just one.
The freezing process now used at Shady Grove Fertility is called vitrification. It’s a relatively new technology that has improved the way embryos are frozen. The vitrification process consists of rapidly cooling the embryos so that little or no damage is done to them. When these embryos are thawed, they are virtually identical to their original state. The quality of the lab work done during vitrification at Shady Grove Fertility is the key factor in the success of our FET cycles. In fact, our embryologists are now training other lab technicians across the country in the nuances of vitrification.
FET Success Rates
One of the primary reasons FETs are so successful is due to the selective nature embryologist’s use when suggesting the embryos to be frozen. “Only really high quality blastocyst stage embryos are frozen,” says Dr. Khan, “so, patients can be sure that they are not wasting their time with an FET cycle. Their chances of success with these embryos are very high.”
The data for 2011 is compiled from the results of all the FET cycles performed at Shady Grove Fertility during the year. It shows both the clinical pregnancy rate and the live birth rate for FET cycles. The clinical pregnancy rate reflects the number of patients who had a positive blood pregnancy test with an ultrasound confirming pregnancy. For FETs in 2011, the clinical pregnancy rate was 57% across all age groups, and the live birth rate across all age groups was 44%.
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The live birth rate shows how many of those pregnancies continued on to the birth of a child.
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These statistics underscore the fact that younger patients generally have more success than older patients when it comes to FET. Women under the age of 35, who did an FET cycle, had a 64% clinical pregnancy rate per embryo transfer. The likelihood of that pregnancy resulting in a live birth was 52%.
However, the success rates are also very good for women over 40 years old. Women over the age of 40, who were fortunate enough to have embryos cryopreserved, had a 38% chance of clinical pregnancy per embryo transfer and a 28% chance of a live birth.
A Second Chance or a Second Child
“The number one reason to freeze is that it’s a great back-up plan,” say Dr. Khan. If your IVF cycle doesn’t result in a pregnancy, you can try again with your frozen embryos with little effort and at a third of the cost.
If you become pregnant on your first IVF cycle, the frozen embryos will be available to grow your family in the future. The cost to store frozen embryos is minimal and Shady Grove Fertility’s onsite storage facilities are a reliable storage option for patients that want to wait a few years before growing their family further.
Dr. Khan adds, “Some patients wonder how long they can store their embryos. There’s really no limit. Their quality doesn’t degrade. Our patients have become pregnant with their frozen embryos as many as five years after their initial treatment.”
Many Patients Have Embryos to Freeze
In 2011, 40% of fresh IVF cycles had one or more good quality blastocyst embryos eligible to freeze. Those good prognosis patients were able to freeze on average 3.2 embryos.
“I always let patients know that we can’t tell them beforehand whether or not they’ll have embryos to freeze at the end of the cycle,” says Dr. Khan, “but, if you are a patient with a good prognosis for IVF, then you have a good chance of being able to freeze embryos. The younger you are, the higher the likelihood you will have embryos to freeze.”
When Will I Decide to Freeze?
Before your IVF cycle begins, you’ll talk to your doctor about whether or not you’d like to freeze embryos. Then, when you come in for your embryo transfer at the end of your IVF cycle, the doctor will have you confirm your wishes and sign off on the patient consent forms.
Within a week after your IVF embryo transfer, your nurse will let you know if the lab was able to freeze and store embryos and how many you have. You’ll also receive written confirmation in the mail.
FET Cycles are Simple
When you decide you want to use your frozen embryos, a pre-cycle ultrasound is performed to ensure there are no cysts or other structural problems within the reproductive system. Then, medications are given to optimize the lining of the uterus for implantation.
The total amount of medication is far less than that given in a fresh IVF cycle. First estrogen and then progesterone is used to build up the uterine lining. Then, the uterine lining is checked once more by ultrasound before the transfer.
“With FET cycles, we don’t need to do the frequent monitoring that we do for an IVF cycle,” says Dr. Khan. “We also don’t have to do an egg retrieval, which is the most costly, and usually the most taxing, part of an IVF cycle for patients.”
Once the uterus is ready, the frozen embryos are thawed and transferred. The actual transfer takes only a few minutes. It is not painful and does not require anesthesia. A blood test to determine pregnancy is performed approximately two weeks later.
Cycles are Lower Cost
Because they don’t require stimulation or an egg retrieval, FET cycles cost less. An FET cycle is about 1/2 of the cost of a fresh IVF cycle. The cost of freezing and storing the embryos is incurred at the time of the IVF cycle. Then, when you are ready to use your frozen embryos, you’ll pay the FET cycle fees.
For patients using the Shared Risk or Multi-Cycle Discount Programs, FET cycles are considered bonus cycles as the cost of the treatment is covered in the initial program fee. Both programs allow for unlimited frozen cycles related to the fresh IVF cycles provided in those programs without counting toward program limits. For example, a patient can do a cycle of IVF and do two cycles of FET before moving onto the second cycle in the six cycle program.
Choosing eSET with Confidence
“Another great thing about our success with FET is that patients can choose eSET with more confidence,” says Dr. Khan. eSET stands for elective Single Embryo Transfer. Patients using eSET have elected to only have one embryo transferred, usually a blastocyst stage embryo, at the time of transfer even though she has more than one embryo available.
Shady Grove Fertility is active in promoting eSET because it reduces the rates of high risk multiple pregnancies – twins and triplets. With the use of eSET, we have found since 2002, that patients have a 1.7% chance of twins and a zero chance of triplets. For patients hoping to avoid a high risk pregnancy associated with multiples this is a great option because it does not impact the pregnancy rates per embryo transfer. Historically eSET patients had a 61.3% pregnancy rate compared to a 60.8% chance of pregnancy for patients that transferred 2 blastocyst stage embryos.
Even though the success rates are high for eSET, some patients still feel they might decrease their chances of success if they don’t transfer all their good, high-quality embryos during their IVF cycle. With FET, patients get the peace of mind of knowing that if they don’t get pregnant on the first try, they can come right back and use those embryos in a simpler, lower cost FET cycle. This allows patient to reduce their chances of a high-risk pregnancy and still have the same chances of getting pregnant.
FET Stacks the Odds in Your Favor
The increase in success of Frozen Embryo Transfer cycles is one of the greatest advances in fertility treatment in the last decade. It provides patients with the ability to get more than one chance at pregnancy from one cycle of IVF.
“FET is such an excellent tool that we didn’t use to have,” says Dr. Khan. “I strongly encourage everyone who is able to do it, to take advantage of FET cycles.”
For more information or to schedule an appointment with one of our physicians, please speak with one of our friendly New Patient Liaisons by calling 888-761-1967.
