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How To Maximize Your Frozen Embryo Transfer (FET) Success
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.