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Highly economical, no risk for the patient, time saving, low and easy to use medication, embryo freezing method has an important place in IVF treatments with high pregnancy rates. Bahçeci Gynecology & Obstetrics, Diagnosis and Treatment Center Gynecology and IVF Specialist Op. Dr. Ali Mesut says that the embryo freezing technique means a new chance for the couple who are receiving IVF treatment and answers our questions:
What does it mean to freeze the embryo?
Reproductive assisted treatments; we call embryos that have the potential to create pregnancy by freezing them with special techniques for later use and storing them under special conditions.
Is embryo freezing a new method?
Yes, it is a relatively new treatment. Pregnancy was achieved for the first time in 1983 from freeze-thawed embryo transfer; but unfortunately it resulted in miscarriage at 5 months. This accelerated the work of scientists and the first live baby birth took place in 1984. In 1984, four live births entered the medical literature as a result of embryo transfer from freezing thawing.
How are embryos frozen?
We use two methods widely in our laboratories. First; slow and gradual freezing technique; very fast vitrification technique. Whichever technique you use, it is important to do the freezing process while preserving the structural integrity of the embryo. To prevent the formation of water crystals in and around the embryo, the embryos are placed in special high-density embryo freezing fluids prior to freezing. Thus, ice crystals, which normally form by freezing water between the cells and within the cell, are not formed and embryo damage is prevented. Because ice crystals damage the membrane and cell structure of the embryos.
How are frozen embryos stored?
The information of the embryos of the patients is recorded in the protocol book, computer and embryology information documents to be put in the patient's file and the embryo is addressed in freezing tanks. Smaller tubes or sticks containing frozen embryos are kept in their places in the freezing tank by noting the patient information and the tank address. These tanks contain liquid nitrogen. Theoretically, embryos can be stored for many years, maintaining their viability at -196 ° C. Currently, however, the storage period of embryos is restricted by legal regulations in force in Turkey for five years.
How many years of frozen embryos is the longest frozen embryo you know?
Following the longest known freezing period, the frozen embryo is thawed after transfer and pregnancy is 12 years. A 39-year-old Israeli woman gave birth to healthy twins in 2003 with an embryo thawed 12 years later.
What are the pregnancy rates of frozen and thawed embryo transfer?
Many factors affect pregnancy rates. In addition to the careful processing of embryo freezing and thawing, the preparation of the inner lining of the uterus and the proper hormonal environment directly affect the success. In our clinic, the pregnancy rate of frozen embryo transfer is the same as that of fresh embryo transfer; I can even say that we got better results.
How do you prepare mothers for frozen embryo transfer?
There are many ways to prepare your mother. The important thing is to bring the uterine lining into a functional state that will accept the embryo. It makes no difference with or without medication. However, our approach is more in favor of medicated and controlled treatment. These medications may vary from patient to patient. This increases the chance of successful treatment for the patient and the problem. The drugs used are not expensive and corrosive to drugs, such as those used to form eggs during IVF treatment. We use drugs that are very cheap and usually taken orally or vaginally. There is no need for continuous ultrasound examination and blood tests. In summary, this treatment method is simple, easy to apply and inexpensive.
At what stage of development are embryos frozen?
Embryo freezing can be frozen at any stage of development from day one to day six following fertilization of the egg. The freezing and thawing protocols at each stage are different. This is determined by the experience, experience and treatment of the IVF team. The difference of good centers emerges here.
When frozen embryos are thawed, are they all thawed healthy?
There may always be deterioration of embryos or some cells during these procedures. In experienced and rigorous laboratories, the risk of degeneration (deterioration) in embryos and cells is very low.
Frozen embryo transfer is done too?
Yes, nowadays, frozen embryo transfer is very common. Frozen embryo protocols account for about 25% of IVF treatments. To date, more than half a million babies have said hello to the world through frozen embryo transfer.
Is there a health difference between the babies born from frozen embryo transfer and the ones born from fresh embryo transfer?
To date, more than 500,000 babies have been born as a result of frozen embryo transfer worldwide. As a result of the researches, it was found that there was no difference in terms of health between these babies and the babies born as a result of other assisted reproductive techniques.
At the 2009 ESHRE (Human Reproduction) meeting in Amsterdam in June, the results of frozen embryo transfer were analyzed. Frozen embryo transfer has become widespread as a reliable treatment method; day after day, the success of the treatment increased.
In a Danish study, it was emphasized that babies born as a result of frozen embryo transfer were born overweight (approximately 200 grams more) than babies born as a result of fresh embryo transfer, premature birth rates were seen less and multiple pregnancy rates were lower. In this study, the babies born in approximately 11 years (1995-2006) were compared with babies born as a result of natural embryos transfer and natural pregnancy in terms of congenital anomalies, neurological sequelae, cancer development and genetic disorders. Fortunately, there was no significant difference between the groups at the end of this study.
In summary, it is known that embryo freezing and thawing procedures do not cause any health problems in babies born as a result of these treatment methods.
When the frozen embryo is transferred, are more embryos placed than fresh embryo transfer?
No, no such rule. The number of embryos to be transferred is determined together with the embryologists, taking into account factors such as the age of the patient, the quality of the embryo, and previous in vitro fertilization (embryo transfer).
Unfortunately, however, some centers are transferring a large number of frozen-thawed embryos, regardless of these factors. This may be due to poor embryo quality. They need more embryo transfers to increase success.