Who Needs Frozen Embryo Transfer? What Is The Procedure Cost of FET And Its Advantages?
There have been several advancements made in the assisted reproductive technologies that have enabled many couples to make a decision well in advance before conception. This is the power of selective reproduction that is delivered through frozen embryo transfer (FET) technique.
Many women who are unable to conceive naturally opt for IVF treatment. During a typical IVF cycle, multiple embryos are produced and depending on your priority, you may donate or freeze them for future use.
Frozen Embryo Transfer
A frozen embryo transfer (FET) is a part of IVF treatment where a cryogenically (low temperature) preserved embryo is thawed (unfreeze) and then transferred or implanted in the woman’s uterus.In most of the cases, frozen embryo transfer is performed from woman’s own embryo additionally created in her previous IVF cycle or may be a donor’s embryo. This procedure is also known as FET-IVF cycle.
Why should one need a frozen embryo transfer?
There are various factors that may lead to selecting the frozen embryo transfer option. These include:
- When your IVF transfer fails, you might need frozen embryos for the next attempt.
- Some people may have additional embryos after an IVF cycle. For instance, let’s assume a woman get five embryos and the doctor only chooses a single for the IVF cycle. Then it means a single embryo will be transferred and rest will be frozen.
- At times, transfer of single embryo does not result in successful pregnancy. In this situation, you have only two options in hand; either to go for full IVF cycle once again or transfer the previously preserved frozen embryos. The second option is more cost effective hence, most couples select this option.
- Sometimes, frozen embryo transfer is required when you want children in future.
- In some cases, embryos need to be genetically screened (Pre-implantation genetic diagnosis (PGD) and pre-implantation genetic screening (PGS) for certain disorders. This is typically done within 3-5 days of post-fertilization through biopsy. However, if there is a situation where genetic testing needs more time, then the extra biopsied embryos are frozen for future use.
- Ovarian hyperstimulation syndrome (OHSS) is a side effect of fertility drugs used during IVF treatment that can be severe, causing loss of embryo. If the doctor suspects that you have increased risk of developing (OHSS), the transfer may be canceled and other embryos are cryopreserved. Because if pregnancy occurs, it can make OHSS more intense and a woman might take longer to recover from the condition.
- A fresh embryo transfer might be canceled in case a woman gets flu or other such illness after retrieving the egg. Moreover, if the doctor sees that the endometriosis in ultrasound needs time to treat, the additional embryos can be frozen for later use.
- When you are using a donated embryo for transfer and want to avoid the complete IVF cycle.
Who is the ideal candidate for frozen embryo transfer?
Like any other fertility treatment, the best age for frozen embryo transfer is under 35. One of the benefits of frozen embryo is that they do not age. For instance, if you freeze your embryo at the age of 30 and decide to become pregnant by 35, the quality, as well as the cell structure, would remain the same as it was 5 years back.
So if you don’t want to become pregnant at an early age or somehow face some fertility problems later in life, you will be still eligible for pregnancy. However, some studies suggest it is best to go for embryo transfer right away after failed IVF cycle.
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Procedure of Frozen Embryo Transfer
Typically, there are two types of FET performed during IVF treatment; one is hormonal support cycle and the other is through natural cycle.
Frozen Embryo Transfer with Hormonal Support
This is the most common procedure that begins at the end of last menstrual cycle, similar to the traditional IVF cycle. First, you would be given injections to stop the reproductivecycle, this could be either GnRH agonist Lupron or medications which suppresses the ovulation.
When your period starts, the doctor will use ultrasound and blood tests to check if all is well.Then you will be put on estrogen supplementfor about 2 weeks to make sure your endometrial lining is up and healthy. It will then be followed by another series of ultrasound and blood tests.
After the estrogen medication phase, progesterone supplements will be added. This could be given either in the form of vaginal suppositories or oil injections. After you have given the hormonal support, the doctor will chalk out the schedule for the embryo transfer based on two parameters; start of the progesterone supplementation and the stage or date of embryo preservation.
For instance, if your embryo was frozen 5 days after egg retrieval, then the preserved embryo will be transferred on day 6th after the start of progesterone supplementation.
Frozen Embryo Transfer Natural Cycle
In this type of transfer, the doctor will not use medications to suppress ovulation, rather it is scheduled based on the natural occurrence of the ovulation.In this case, timing becomes extremely important. You might be continuously monitored either at a fertility clinic or at home using ovulation prediction kits. But in most cases, you will be monitored in the clinic itself as ovulation prediction kits aren’t fully reliable.
When the doctor detects ovulation, you will be put on progesterone supplementation before the embryo is transferred.
Implantation of frozen embryos is done in the same way as of fresh embryo transfer. Once they are thawed and warmed up to the body temperature, a thin flexible tube (catheter) is inserted into the vagina which goes through the cervix in the uterus and the embryo is transferred. Within 6-10 days, the embryo will implant itself in the uterine lining.
Risks of Frozen Embryo Transfer
Compared to a complete IVF cycle, frozen embryo transfer has lower risks. Below are mentioned some of the risks and complications associated with frozen embryo transfer.
- There is a slight risk of having multiple pregnancies.
- Ectopic pregnancy
- Low risk of Infection
- Lower risk of Birth defects
- Low risk of stillbirth
- Low birth weight
- Low risk of premature birth
Advantages of Frozen Embryo Transfer
There are several advantages of choosing a frozen embryo transfer. It opens up a plethora of options for you.
- Frozen embryo transfer gives you additional chances of conceiving
- It is easier process as you don’t need anesthesia and surgery
- It is less expensive than going for a fresh IVF cycle
- Reduced risk of ovarian hyperstimulation syndrome (leakage of fluid in the abdomen and chest)
- Allows genetic testing of the embryo before implantation
- It gives freedom to expand family at a later date
Success rates of frozen embryo transfer
With the advances being made in assisted reproductive technologies, the success rates are increasing. As the risk of OHSS is reduced, the success rates automatically rises. The success rate of frozen embryo transfer (FET) is over 30 percent, which still seems to be promising.
Cost of Frozen Embryo Transfer in India
As compared to full-fledged IVF cycle, FET cost in India is significantly less. The average cost of FET in India can be in the price bracket of Rs. 20,000 and Rs. 40,000. You may have to spend additional Rs. 4,000 to Rs. 6,000 every year for preservation maintenance.
The price excludes the expenditures you will make on initial IVF treatment, medicines, ultrasound and blood tests.Also, in case you are taking donor embryo, the cost may vary, it could be between Rs. 40,000 and Rs. 60,000.
It’s not easy to make a decision on what is best for you. But the doctors and fertility experts may guide you better. If you are serious about making babies using FET technique, make sure you discuss all your queries with the doctor to plan accordingly.