Fresh vs. Frozen Eggs: the Pros and Cons
There are a lot of big decisions to make when it comes to building a family. For those who choose to undergo in vitro fertilization (IVF), one of the decisions they will have to make is whether to use fresh eggs or freeze them. When weighing options, look at the pros and cons of both sides and see what is right for you.
With a fresh transfer, the embryo transfer typically occurs about 3-5 days after the egg retrieval. With a frozen embryo transfer cycle, the embryo has been frozen for a period of time, even years, and thawed prior to transfer.
Regardless of the type of transfer, the endometrium (the lining of the uterus) needs to be prepared for the embryo to implant. The clinician will check the thickness of the endometrium via ultrasound to ensure appropriate thickness and quality. If it is a fresh transfer, the endometrium is prepared by the estrogen produced by the ovarian follicles. If it is a frozen transfer, the endometrium is prepared with the help of estrogen patches, pills, or injections.
Why would someone freeze their eggs?
There are many benefits to freezing eggs prior to an embryo transfer. Sometimes, patients have embryos left over from a fresh cycle. These embryos can be frozen for later use in case the transfer doesn’t result in pregnancy, pregnancy loss, the patient has had a baby and would like to have another, maternal age, or the patient would like to have a baby via gestational carrier. While gestational carriers can still be involved in a fresh transfer, IVF clinicians often find it easier to do a frozen transfer in these situations. This is because the carrier needs to be in a specific phase in her cycle and the uterus has to have an adequate lining.
Choosing to undergo a frozen embryo transfer instead of a fresh transfer with a gestational carrier or egg donor can help reduce prevent delays or cancellations. Factors that may cause delays include the egg donor not passing the screening criteria, ovarian cysts, COVID and other illnesses, or a negative reaction to cycle medications. Frozen embryos can also be genetically tested for abnormalities.
Why would someone prefer a fresh transfer?
The most obvious pro is that it is a shorter overall wait for a fresh transfer rather than a frozen transfer. They are typically performed within a few days of egg retrieval.
Some insurance companies do not cover the cost to freeze embryos, known as cryopreservation. Some patients choose fresh transfers because it is more affordable. However, if the fresh embryo transfer does not result in pregnancy, frozen embryo transfer may be the more financially efficient option depending on the number of transfers needed.
There are a lot of studies with varying results about whether fresh embryo transfer or frozen embryo transfer is the better option. These studies may indicate that babies born via one method are healthier than the other or that one method has a higher rate of live birth than the other. There is no conclusive study that answers the question for each individual who asks “Should I choose a fresh embryo transfer or a frozen embryo transfer?” Your IVF clinician can help answer this question if you are unsure what the right fit for you and your growing family is.