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'Frozen embryos are as good as fresh ones for IVF births'

12 January 2018

Women undergoing IVF using frozen embryos have just as much of a chance of having a baby as those using embryos that haven't been frozen, a study has suggested.

The researchers found that women using frozen embryos had a live birth rate of 48.7%, versus a live birth rate of 50.2% for women in the group where the embryos weren't frozen.

In a study - published today (Jan. 10) in the New England Journal of Medicine - researchers compared the live birth rates of in vitro fertilization procedures on women who had infertility but otherwise ovulated normally.

This discovery means that doctors treating patients who don't have PCOS may now implant one embryo at a time instead of multiple embryos at once, which can often lead to multiple births.

After an earlier study by the Chinese team showed that frozen embryos were better for women with PCOS, "a lot of people jumped to the conclusion that we should always do frozen".

Coutifaris says that it's clear that frozen embryos are more effective for some women undergoing IVF, specifically women who have PCOS or who may be prone to hyperstimulation when they are treated with hormones.

The study found the rates of pregnancy and live births were comparable when women were implanted with either fresh or frozen embryos. "Some programs around the country won't do fresh transfers anymore", said Dr. Christos Coutifaris of the University of Pennsylvania's Perelman School of Medicine in Philadelphia, who was not connected with the new research. "So to apply the rule to everybody that we should freeze your embryos is probably not correct".

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Freezing embryos also allows couples to take advantage of genetic testing, which can pick up potentially lethal genetic diseases and guide doctors in deciding which embryos to implant.

Rates of ongoing pregnancy occurred in 36 per cent of the frozen-embryo group and 34.5 per cent in the fresh-embryo group, according to the study. Secondary outcomes included rates of pregnancy complications (ovarian hyperstimulation syndrome, ectopic pregnancy, congenital anomaly), birth weight, rates of pregnancy loss, and comparisons of biochemical pregnancy and clinical pregnancy characteristics.

While many clinics are moving completely away from fresh embryo transfers, the freezing process adds additional costs in IVF and does not result in higher rates of live births. Researchers called this an "insignificant difference".

They also acknowledged several limitations, such as the limited generalizability due to the study's single center nature, and using only the Cryotech vitrification method.

Neither study found a higher risk of neonatal or obstetrical complications in either group, although frozen embryo transfer produced a statistically lower risk of over-stimulated ovaries, which leads to swollen and painful ovaries and is potentially risky.

It was the Chen group that, in 2016, reported that frozen-then-thawed embryos offered a 7-percentage-point edge when it came to producing live births among infertile women with polycystic ovary syndrome: 49 percent versus 42 percent.

'Frozen embryos are as good as fresh ones for IVF births'