fresh vs. FET vitrification stats

fresh vs. FET vitrification stats

Joined: August 4th, 2011, 8:18 pm

April 11th, 2012, 4:34 pm #1

It seems like there is no difference in pregnancy stats between fresh transfers and those with FET vitrification. Am I reading the stats correctly? Is this because with vitrification there is not much damage to the embryo? I guess also the meds are out of your system and perhaps these impact the lining and make it less receptive to implantation? In general, if you had a choice, is it still better to go with fresh?
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DeeinNYC
DeeinNYC

April 11th, 2012, 5:59 pm #2

At a good clinic, I don't think there is much difference. If I had the choice, I would do a FET over a fresh cycle any day as long as the clinic vitrifies. I once did a "natural" FET and it was by far the easiest of all ART procedures that I have ever done. I also like the fact that when you do a FET there has been an opportunity to clear your system of most of the meds. I feel that this can only be a good thing. The only caveat is that some clinics have truly abysmal FET rates as compared to fresh.
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sophie
sophie

April 11th, 2012, 9:36 pm #3

I wanted to add that a year or so ago, I was very interested in FET stats (my clinic's FETs stats beat their fresh in my age group. I actually emailed the SART people and was told that the age listed for a FET was the age at transfer-- NOT at freeze. So the embryos may have been a few months, or many years "younger" than the age listed for the patient at the time of the FET. I think this accounts for at least some of the higher than expected FET success.

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Joined: December 20th, 2010, 7:38 pm

April 11th, 2012, 9:38 pm #4

It seems like there is no difference in pregnancy stats between fresh transfers and those with FET vitrification. Am I reading the stats correctly? Is this because with vitrification there is not much damage to the embryo? I guess also the meds are out of your system and perhaps these impact the lining and make it less receptive to implantation? In general, if you had a choice, is it still better to go with fresh?
because I assume that you are doing minimal-stim at New Hope, and I am using CCRM as a reference because we know their lab is excellent.

Live birth per transfer for the age group 41-42
fresh: 6% FET: 11.1%

Live birth per transfer for the age group 42+
fresh: 1.7% FET: 7.2% (I personally consider 7.2% very encouraging as opposed to widely believed 1% live birth for 42+, because NH takes a lot older patients)

Not only that, if you look at the other age groups, FET live birth rate is consistently higher than fresh.

Also look at CCRM, you see the same pattern. Far fewer people bank at CCRM (at least not to the same extent like at NH where people bank for over a year, because it is too expensive), so the FET retrieval age will be closer to the transfer age.

Live birth per transfer for the age group 41-42
fresh: 24.4% FET: 43.1%

Live birth per transfer for the age group 42+
fresh: 10.9% FET 19%

I think the conclusion is very clear. If your lab is competent, go FET.
Last edited by miraclex2 on April 11th, 2012, 9:39 pm, edited 1 time in total.
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Joined: December 20th, 2010, 7:38 pm

April 11th, 2012, 9:49 pm #5

I wanted to add that a year or so ago, I was very interested in FET stats (my clinic's FETs stats beat their fresh in my age group. I actually emailed the SART people and was told that the age listed for a FET was the age at transfer-- NOT at freeze. So the embryos may have been a few months, or many years "younger" than the age listed for the patient at the time of the FET. I think this accounts for at least some of the higher than expected FET success.
Yes, what you mentioned could be a factor, but I think it has more to do with FET with blast. Not all, but an overwhelming majority of FET are blasts. Growing blast is already a process of weeding out the weakest, because the weakest wouldn't make it to freezing grade anyway. Also, for older women, most Drs chicken out and transfer d2 or d3 for fresh because they don't want their patients walk away feeling crushed on day 5/6 if there are nothing to transfer.

My RE told me about a current patient of his that went to a famous SoCal IVF center and went through several completely stupid transfers that should have never happened. Once she produced 12 eggs, and on day 5/6, there were two 12-cells, one very low grade morula. My RE said that her chance of pregnancy is 0, and the doctor should have never let her go through with transfer. That puts extra hormone in her body that she doesn't need, and extra emotional stress of 2ww. My RE said many REs encourage patients to go through with fresh transfer for psychological reasons - so that the patients feel like they have accomplished something and there is still hope. As a result, fresh transfer is not as scrutinized as FET, because all the labs have a stricter guideline on what grade of blast to freeze.
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alima
alima

April 11th, 2012, 10:16 pm #6

because I assume that you are doing minimal-stim at New Hope, and I am using CCRM as a reference because we know their lab is excellent.

Live birth per transfer for the age group 41-42
fresh: 6% FET: 11.1%

Live birth per transfer for the age group 42+
fresh: 1.7% FET: 7.2% (I personally consider 7.2% very encouraging as opposed to widely believed 1% live birth for 42+, because NH takes a lot older patients)

Not only that, if you look at the other age groups, FET live birth rate is consistently higher than fresh.

Also look at CCRM, you see the same pattern. Far fewer people bank at CCRM (at least not to the same extent like at NH where people bank for over a year, because it is too expensive), so the FET retrieval age will be closer to the transfer age.

Live birth per transfer for the age group 41-42
fresh: 24.4% FET: 43.1%

Live birth per transfer for the age group 42+
fresh: 10.9% FET 19%

I think the conclusion is very clear. If your lab is competent, go FET.
you're right - the stats do speak for themselves. So then I wonder why more clinics that do vitrification don't push for the FET. The success is about two times that of fresh in both clinics. I guess then the meds must do something to your lining which makes it less receptive to implantation.
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Joined: December 20th, 2010, 7:38 pm

April 11th, 2012, 10:23 pm #7

Drs themselves want to see closure to each cycle as well. I don't think they are necessarily motivated by money, but pushing a patient to grow blast takes some guts, because the patient may end up with nothing to transfer on day 5/6 and the doctor feels horrible as well.

That is why I see mini-IVF doctors pushing for blast more so than conventional doctors, because with the former, the patient typically buys a 2-3 cycle package so that they are more psychologically prepared for failure in a cycle or two, and in the latter situation, the patient expects to be successful in one shot. The patient expectation is very different, and part of the Dr's job is to manage patient expectation.
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Jamie
Jamie

April 11th, 2012, 10:58 pm #8

I think it's so, so important that labs are able to competently grow embryos to blast because too many 40+ women have false hope and extra weeks of hormones in their bodies thanks to day 3 transfer. It's highly possible that if they had gone to blast there would not have been any embryos to transfer and they can skip all that and move forward (as well as additional disappointment with the BFN). I know docs and patients want to have something to transfer but if it's not going to work that cycle I'd rather know sooner rather than later so I can skip all the progesterone and start thinking about my next move.

For younger women it can be bad too . . . docs tend to put more embryos in which can lead to higher-order multiples. Even a straggler on day 3 can turn into a live birth for a younger woman. Much better to culture to blast and then transfer one or two at most, while vitrifying everything else left.

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DeeinNYC
DeeinNYC

April 12th, 2012, 12:45 am #9

you're right - the stats do speak for themselves. So then I wonder why more clinics that do vitrification don't push for the FET. The success is about two times that of fresh in both clinics. I guess then the meds must do something to your lining which makes it less receptive to implantation.
And I do not think prove the point made. You have to remember that a VERY large portion of CCRM FET's are done AFTER genetic testing. Of course their FET stats will be better than fresh as they will only transfer genetically normal embryos in a large amount of these FET's. You are not comparing apples to apples here with respect to CCRM. I believe that nationally, fresh transfers still have higher success rates.
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Joined: December 20th, 2010, 7:38 pm

April 12th, 2012, 1:05 am #10

I think a better research can be done just by looking at labs with vitrification but NO genetic testing and little banking.

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