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How To Maximize Your Frozen Embryo Transfer (FET) Success

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Frozen Embryo Transfer

For many fertility patients, getting over the first hurdle of a fresh IVF cycle can be a relief. But if you’ve experienced a failed IVF cycle and want to try again, want to avoid ovarian hyperstimulation syndrome (OHSS), or want to build your family further, you might be considering a frozen embryo transfer (FET) IVF treatment.

Frozen embryo transfers involve the use of thawed embryos that were frozen in a previous in vitro fertilization (IVF) cycle. Frozen embryos can remain frozen for up to 10 years, though freezing techniques and quality of the embryos influence the survival rate of the embryos.

While a fertility patient will have little control over the outcome of the embryo thawing process, there are several ways she can prepare for a frozen embryo transfer to optimize her odds of successful pregnancy.

Noel Peng, M.D., F.A.C.O.G., of IVF Institute in Dallas, Texas, advises patients that creating the optimal environment for embryo implantation and maintaining good health are essential for a successful frozen embryo cycle. “One good thing about using frozen embryos is that the risk of aneuploidy is locked in at the age of which the embryos were frozen. However, mature women have an increased risk of high blood pressure, diabetes, and fibroids which can influence the outcome of their cycle,” he says. These health conditions will not only jeopardize the success of a cycle, but may also increase the risk of miscarriage and pose risks to the fetus once the mother achieves pregnancy. Due to the effects of age on fertility, it is important to not wait too long before returning for your frozen embryos.

Dr. Peng recommends fertility patients be mindful of their health and have realistic expectations about success rates and embryo quality when pursuing a frozen embryo transfer:

  • Optimize your overall health. Regular physical examinations, gynecological evaluations, and a thorough workup with your fertility doctor are recommended before a frozen embryo transfer cycle. Take vitamin supplements, including folic acid. Fertility patients should also quit smoking and limit alcohol consumption to promote the best outcomes.

  • Be aware of developing health conditions. Hypertension (high blood pressure) and diabetes can worsen during pregnancy and pose risks to the fetus.

  • Take frozen embryo transfer success rates with a grain of salt. Success rates depend on the number of cycles a clinic performs and the complexity of cases accepted into the clinic. Understanding how age and diagnosis cut offs influence IVF success rate data is important for seeing the bigger picture. There are many other factors that influence your personal success rate including body mass index (BMI) and underlying fertility conditions are some examples.

  • Consult a trusted fertility doctor for a realistic assessment on the quality of your frozen embryos. Embryos frozen via slow-freeze techniques are at greater risk of perishing during the thaw process. Embryos frozen with vitrification endure less ice crystal formation and are at less risk of cell rupture during the thaw process. Better quality embryos will have a higher survival rate as well.

“Before a patient undergoes a frozen embryo transfer, I recommend checking the hormone levels to be sure they are balanced, screening for thyroid disease, and examining the uterine cavity. Especially if the patient has been pregnant and delivered a baby through c-section (caesarian section), scar tissue can affect the uterus as well and can make it difficult for the embryo to attach. You wouldn’t want to put the embryo back if uterine conditions are not optimal,” Peng advises.

Fertility patients concerned about the risks of chromosomal abnormalities or have had an unsuccessful frozen embryo transfer should talk to their fertility doctor about preimplantation genetic screening (PGS). Though Dr. Peng cautions patients to weigh the risks versus the benefits, he says it is possible to biopsy previously frozen embryos to test for balanced chromosomes.


Comments (64)

Has there been any studies regarding this? We have male factor infertility, got pregnant on our first IVF fresh cycle (transferred Two day 5 blastocysts) resulted in a healthy baby girl. Now looking to the future and our 3 frozen day 6 embryos that we have left. I've heard of some FET's and doing a "natural" cycle with no medications, do you know anything about this? thanks!!!

I am interested in a natural cycle frozen embryo transfer as a surrogate. I do not tolerate estrogen because of factor five Leiden but have had two successful pregnancies of my own while taking anticoagulants. Is a natural cycle FET possible for a surrogate with factor five? If not can you please give a detailed -why not. We seem to be getting the run around. I'd just appreciate an open mind and a detailed answer. I feel like people are forgetting these parents would do anything to have a baby- cant we also consider everything with an open mind? Thank you for your time!!

Hi Amie,

I have not heard of natural cycle protocols for surrogates. You would have to consult the doctor or agency with which you are listed as a surrogate. Best of luck to you!


Hi Amie,

I can not say for sure as I am not a doctor, but it is likely because doctors have the most control over medicated cycles where they can shut down natural hormone production.


Hi there. I had my tubes removed after surgery showed them blocked/damaged when I was 26. First ever IVF right after which resulted in beautiful, healthy boy May 2010. 1 year later FET resulted in missed miscarriage 8 weeks. 1 year after that IVF resulted in chemical pregnancy 4 weeks. Another IVF BFN. Finally successful FET Christmas 2013 but heart stopped beating and I gave birth to my beautiful angel daughter at 17 weeks pregnant on April 1, 2014. FET again last month another chemical pregnancy 3 weeks. Am I hopeless? I feel like all these drugs are going to increase chances of cancer. Should I just quit? Am I going to have miscarriage ever time!

Dawn, I'm so sorry for all that you've been through, and hope that in the last three years since you wrote this, you have had a much better experience with the fertility treatments. My question was, have you done the chromosomal testing? We are preparing for our first FET and while 5 embryos made it to the blastocyst stage, only 1 was chromosomally normal. I think often about how sad it would have been not to have known that those 4 were not compatible with life and to have gone through 4 unnecessary pregnancy failures and/or miscarriages. So that might be something to consider, if you want to. It's hard to get any bad news from the lab, but it seemed much easier to me than going through the process in my body of finding out.

Hi Dawn, I'm so sorry to hear about your struggles to build your family. It sounds like you might benefit from a second opinion. If you want, I would be happy to provide some references and reviews of doctors in your area. Please email me at

I just got confirmation that our fresh first IVF cycle failed. On day 3 two (one 7 cell, one 8 both low fragmentation) were transferred. Three more made it to healthy day 6 blasts and were frozen through vitrication (correct word?). They transferred on day three because they were worried none would make it beyond that day but 3 did bounce back. For that reason we are hoping we have a better shot with these more mature embryos and also with a non stim cycle/no retrieval procedure. Am I thinking along the right track? Also is there any compelling research on waiting a cycle in between a failed fresh transfer and an FET? Assuming my progesterone level goes back down a little more (just had beta today) my clinic says there is no need to wait. Thank you!

Hi Amber,

You are one smart cookie! When an embryo reaches day 5 and beyond, it is almost like nature's way of genetically testing the embryo. If it survives that long, it is more likely to develop into a healthy pregnancy. You asked about research on FET studies. More and more doctors are moving toward a freeze all cycle to allow the uterine lining time to recover from the harsh effects of fertility drugs. Check out Dr. Grifo's STEET study at NYU:

I am wishing you the best of luck at your FET! My fingers are crossed for you.


Hi I am 38, had 3 failed IUI attempts and just in the midst of my first IVF. Retried 13 eggs, 10 fertilized. We have no family history of chromosomal abnormalities but are doing PGD anyway (our clinic biopsies the part of the embryo that becomes the placenta, not the fetus itself). 5 blastocysts were biopsied on Day 5 and 3 more on Day 6. Few questions, as await PGD results: 1. if 8 made it to blastocyst phase, does this mean they are more likely to result in live births? 2. Is it a good thing or bad thing that the 3 were not biopsied on day 5 but rather on day 6? 3. Statistically speaking, what's the likelihood that chromosomal abnormalities will present? Thanks, Anna

Hi Anna,

You have some excellent questions here! Typically, fertility doctors say that making it to blastocyst stage is nature's form of PGD. The embryos that make it that far are more likely to develop into a healthy pregnancy. The other two questions are best suited for your particular clinic. Each clinic has their own way of doing things and I would hate to give inaccurate information. You should consult your doctor.

Best of luck to you on your IVF cycle!


Hi, I am 30 yo, really healthy, I don't drink. I was diagnosed with pcos but I don't agree with the diagnosis bc I don't have any of the symptoms other than me not getting pregnant. I did ivf. I had 15 eggs in blastocysts. Transferred 2 for ivf and failed apparently bc my estrogen levels were too high. I just did fet with 2 blastocysts again and everything went well. The re always tells me that I am a text book case, very straight forward and everything goes well except for the transfer. It was a little more difficult bc he was having a hard time finding the area to implant and the embryos got stuck in the catheter. If don't understand why it failed if all my levels were good. What do you guys think?

Hi Riri,

It sounds like you might benefit from a second opinion. Do you have regular periods? Hormone Imbalance? If you'd like us to provide some references and reviews of doctors in your area, give us a call at 1-855-955-BABY (2229).


Hello Natasha,
Good luck with your treatment. We are not doctors nor can we provide any medical guidance, however while undergoing treatment a patient should not be smoking.
Please reconsider to other forms, such as yoga or meditation for a form of stress relief.
Thank you,

What effect if any does smoking cigarettes have as far as an embryo attaching after a frozen transfer ? I have been monitored with estrogen and progesterone shots / pills my levels are great and wall lining is great. I quit several months before my first transfer but started lightly back after it didn't take. I still unfortunately smoke a few a day and had my second transfer yesterday. I know I need to quit but want to know if honestly what I do smoke will have any impact on the embryo taking ?

Hi there, I have a query for no. Of day 5 embryo that can be frozen. I am 26 years old. First ivf_ 28 eggs_ 27 firtilised_23 day 5 blastocysts. But now my doctor says that only 6 were frozen how is this possible? Because they were all day 5 blastocysts and capable of being able to freeze. I also suffred from Ohss and they had to cancel my cycle. What is the % of frozen transfer to pregnancy? Does it reduces the chances of getting pregnant or is it good for conceiving? I am worried if the frozen have the same capability like fresh ones to implant. Could you please shed some light on my query? Also is there any possibility that they intentionally didn't freeze all? Even though they were good day 5 blastocysts. Thanks

Disculpe yo tengo obstrucción de trompas me hice un Ivf fresco y al 5 día me vino la regla después de la transferencia y salió negativo el siguiente mes intente con la fet pero el 7mo día tenía unas pequeñas ligas cafés y ala hora de la beta salió negativo tube 3 hijos anteriormente no se qué pasó ahora estoy tomando vitaminas par intentar de nuevo tengo 3 embriones congelados hay algún tipo de examen que pueda hCer antes de intentar por favor ayúdeme tengo 36 años

Hi, I'm 33 and we have male factor infertility. We have done 2 fresh IVF (ICSI) and 2 FETs without success (1st fresh transfer was ectopic). Doctors have no answers for why; all of my tests including hsg have been normal, and I've responded well to each cycle, except the first I had mild OHSS. We have 2 frozen grade 3 embryos (5 day blasts) that we are preparing to transfer in a few weeks. If that fails, they recommend PGD on the next fresh cycle (we have not done it yet-the doctor has had no specific reason to do PGD until now). Any advice?? I also do yoga, meditation, acupuncture, healthy diet.

Hello Kelly,
I am sorry this has been so difficult. Before we decide to do PGD which is definitely a very effective test, I would suggest seeking a 2nd opinion. Doing 5 cycles with this clinic, I would want a fresh pair of eyes on my records and past cycle sheets. Please feel free to call our PCAs and they would be able to further assist you. They can be reached at 855-944-2229.
Looking forward to hearing from you.

Thank you Bhavi. We have had 2 second opinions review everything, and they have come up with few suggestions, based on everything looking "perfect on paper" for IVF w ICSI. One doctor advised getting my husbands karotype and y-chrom deletion tests, which were negative thankfully. The other doctor suggested PGD and said that the lab at our clinic, although it has 40% success rate, may not be as good as other labs in the country with 60% success (SART). Since we purchased a package of 3 fresh and 3 frozen cycles at this clinic, we feel obligated financially to finish up our remaining 2 cycles and hope for the best each time. Any other ideas are appreciated.

I understand your situation a lot better. Thank you for your feedback. You can still have your records reviewed by another RE just to get an opinion. Having the financing package is a big help, however it does limit you.
Please let me know if I can be of any further assistance.

We are trying our very first IVF treatment. My wife had 6 mature ones and 2 transferred, but this morning we found out that she was not pregnant. How long before we can start the 2nd FET? Is there something else we need to do now? We are kind of desperate and very much disappointed now. We suspected in the first FET that there was something wrong while transferring as the doctor said he couldnt induce the eggs at correct place initially. What does that mean? And then he tried again and it was OK. But my wife is still in too much pain. Do you reckon that the failure was something to do with it?

Hi there,

You should be able to try an FET with your wife's next cycle.

Best of luck,

I have 1 failed ivf cycle... my embryos are not transfered on fresh cycle because my endometrium lining has been increased to 18 mm. So dr did Frozen Embryo Transfer for 2 times and it is failed. Next time embryos are not transfered in fresh cycle because of high endometrium lining. And Dr did the Frozen Embryo Trannsfer with one A grade 6 cell embroy and one A grade 7 cell embryo. I want to know that how much it is important to watch endometruim lining for fresh embryo transfer?

Hi, I have done fresh embryo transfer from egg donor and lately FET #1 and it was BFN. I wonder what went wrong. I have endometriosis, cyst ( or fibroid i guess ) and blockage fallopian tubes. I did a fibroid removal inside my uterus last June 2012. During both time of embryo transfers, they have some difficulty to enter the uterus with the catheter. Is it scar tissues? Is there anything I can do to get higher chance of embryo implantation? Thx

My wife has four failed attempt of IBF et What should I do now.

I'm so sorry to hear about your failed IVF cycles. I don't know if you've used the same doctor, but I would recommend a second opinion to review your medical records and your previous IVF cycles. If you'd like more information, including help finding another doctor in your area, our Patient Care Advocates can help: 855-955-2229 or Best, Claire

The most important thing is to be mindful of a healthy lifestyle including taking a prenatal vitamin, no drinking or smoking. Wishing you all the best!

I had 2 failed fresh ivf cycles and I'm about to start a fet with a 2ab grade embryo,is there anything I can do to increase my chances for a successful outcome?

There are no foods that will help the transfer take, but you should be taking a prenatal vitamin, eating a healthy diet and using no alcohol or tobacco to get your body ready for baby. All the best, Claire

hi I have had two failed icsi, iover stimmed my last go, they said I have an high hormone is there anythink I could do to have a positive outcome

Will fibroid affect fet? I am planning for fet.

A fibroid can interfere with embryo implantation - it depends on where it is located.

my wife got 2 attacks of severe hyperstimulation syndrom and the second was very severe with shock .can she try anothrer ivf.

You should speak to your fertility doctor about this or get a second opinion. There are a number of issues that can cause severe hyperstimulation - and you should determine the cause if you are thinking about an other IVF cycle. Best, Claire

Hello Im 25 years old had my first transfer ever in June 2010 and I delievered in Feb 2011 now my question is will I still have a good outcome of the frozen transfer and what can I eat and take to up my success Waiting Patiently In Indiana Erica

Congratulations on your baby! The most important thing is the quality of your embryos - you should check with your fertility doctor about that. You'll want to maintain a healthy lifestyle so that your body in great condition for the transfer. All the best, Claire

Hello I am 35 I had a 3 day transfer and on the 14th day I had spotting nurses said it was normal on the 20th day I had a horrible back pain and had a miscarriage, very sad we have 6 frozen embryos and I concern that will happen again any long should I wait to try again with the frozen embryos.

Hi, I just had my first fresh IVF and it ended in a chemical pregnancy. We have male factor infertility due to a vasectomy. I am 29 yo, healthy and no fertility problems. Stimulated well, 16 mature eggs, 10 fertilized with icsi, and 3 made it to 5 day blast. Transferred one excellent blast with two good embryos frozen on day 5 and 6 with vitrification. Very disappointed by the chem pg but doc said its a good sign and encourages the FET. Question, should I try sET again or go with both blasts? Thanks!

Hello, I have just had my second failed IVF attempt. We had one AA grade, hatching blastocyst transferred, but sadly it did not implant. We have 3 AB grade blastocysts left. Our fertility issue is male factor. My BMI is 34, which will play a bigger role in success - age or my weight? My instinct is to go for a frozen embryo transfer as soon as possible, I am 32, but should I take a year to Louise weight first? Thank you for your advice.

I'm so sorry to hear about your second failed IVF. I think that's a really good question and we would be happy to help you get a second opinion. I do think it's so important to get as much information as you can. You can contact our Patient Care Advocates at 855-955-2229 or All the best, Claire


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