Fresh transfer versus frozen?

bionerdsteph

 Doing IVF in June. We've made the decision to do PGS & freeze everything if there are 3+ embryos, debating if there are fewer & if to just do a fresh transfer or freeze. I'm leaning towards frozen since there is a lot of evidence mounting that a highly stimulated uterus after IVF show worse results & freezing has gotten so good they don't usually lose embryos. Any thoughts or opinions out there? Or a thread I missed discussing this? 

Cowboycorgi

For me, it would matter if my doctor felt like I was at higher risk for oohs after retrieval or pregnancy. If he felt I was low risk, and I only had 1-2 embryos I would just do a fresh round. 
If he felt I was higher risk, and my embryos would benefit from waiting, I would freeze. 
However, I don't hold much stock in PGS testing. So if I only had 1-2 embryos, I wouldn't bother testing at all. 

But like I don't know your history or background, so take what I say with a grain of salt. Just what I would personally do if those were my options. 

akcrowe

We've done fresh and frozen, all PGS tested. The fresh wasn't successful and my doc had no idea why. He thought I was a perfect candidate for a fresh. I thought it was just too much for my body- but I have no clue. We were successful with the frozen but lost her in the 2nd trimester. I personally believe in PGS testing because we went from 12 embryos on day 5 to 6 after the testing.

We just did our 4th transfer and are in our tww.

Good luck whichever route you go!

notamyrtle

I would definitely freeze, especially if you think you might be a 'good responder' to the meds, for the reason you stated (uterine receptivity may be off, especially if estradiol is quite high). If your clinic does vitrification (and most clinics do now), that's pretty much as good as it gets. 

notamyrtle

A bit more info - this is more a personal preference, but I think it's psychologically a lot easier too. The last thing I wanted to think about after stimulation and retrieval was more medications and injections, and the inordinate stress of a two week wait. Just my two cents. 

[Deleted User]

@akcrowe. I'm confused.  I thought they could only do pgs on frozen...
<img src="https://us.v-cdn.net/5020794/uploads/editor/wh/fbfu9zh6nd8h.gif" alt="">

cashewchicken

@BusinessWife- Some PGS companies have a fast turn around time so that the blast biopsy results are in by day 6 or 7. Some even biopsy day 3 embryos. I've also heard of clinics with their own CCS/PGS instrument that allows in-house analysis of samples, which would definitely shorten the time to result.

As for the topic question, since I was going for embryo banking and pgs testing, frozen transfer was the only way to go. With improved freezing methods, viability of frozen embryos has gone up and from what I remember, implantation/pregnancy rate is not that much different from a fresh transfer. Some stimulation methods (antagonist, for example) have also been shown to result in reduced pregnancy rate when fresh transfer is performed, compared to other protocols.

caseyw8784

@BusinessWife - just commenting that i love your gifs!

bionerdsteph

Thanks everyone! I think we're going to freeze & have a month break so I can do a week long intensive work trip without fearing a MC in the middle of a conference room 2,000 miles from home. I only travel 1-2 times a year for work & this is an important opportunity for me so decision made.

The fertility center I'm going to has their own molecular biology lab & does the PGS in house! PGS science is super solid, but with the freezing + PGS testing it's $5k more than a fresh transfer & we are all OOP past testing. I think it'll be mentally worth the money though to reduce the MC rate. I'm pretty worried about that.

MMD1986

caseyw8784 said

@BusinessWife - just commenting that i love your gifs!

That puppy one definitely made me smile this morning. 

Sugarbreak

If I had the chance (with 3+ embryos making it to blast) I would've definitely gone with a freeze all/PGS.

But for cycle #1, none of my embryos made it to blast. And for cycle #2 (current cycle), I only had 1 5-day blast. So we ended up going with a fresh transfer. I didn't want to wait or spend the money to test one embryo. So I think it's great for you to figure out different scenarios with your RE.

i-wanna-b-the-girl-w-most-cake

I'd say go with how you feel after the retrieval. I had the same ? as you and ended up going with a fresh transfer because RE was afraid our embryos wouldn't make it to day 5 (we ended up with 3 that did after transferred 2 on day 3). But my levels were good enough to go with a fresh and even tho DH thought we should do frozen for reasons you mentioned, I was getting impatient and prob would have decided with fresh even if embryos looked good on day 3. Despite how I felt because i was very very sore after the retrieval. I still think the fact we did a fresh was a reason it didn't work as I was still in a lot of pain 3 days after the procedure. Good luck!

Hopeful_mom

akcrowe I'm so very sorry that happened to you!!  Do they know why you MC?  Best of luck in your tww did you transfer 1 or 2?  Hope your bean is getting all comfy and cozy sending u sticky vibes!!  Looking at the dates I'm hoping you got your bfp!

bionerdsteph I"m glad you made a decision you're comfortable with!  Luckily theres success rates with both!  I would love to do a fresh transfer.  I did a 3dt and got pregnant with twins unfortunately (tw) I lost them at 10wks and it was bad.  I'm now 41so since time is no longer on my side we're doing PGS/frozen.  Am I happy with that decision no BUT its just out of my hands.  Since I have been trying to bank some embabies I still wanted to do a fresh transfer with a frozen embaby after ER but the success rate on that isn't as high and RE doesn't recommend it....doesn't mean I still dont want to try it