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Infertility Podcast Series: Journey to the Crib: Chapter 22: Cryopreservation of Embryos

By David Kreiner MD

August 16th, 2012 at 5:44 pm


Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Twenty-Two: Cryopreservation of Embryos. You, the listener, are invited to ask questions and make comments.  You can access the podcast here: 

Cryopreservation of Embryos 

In 1985, my mentors, Drs. Howard W. Jones Jr and his wife Georgeanna Seegar Jones, the two pioneers of In Vitro Fertilization (IVF) in the Western Hemisphere, proposed the potential benefits of cryopreserving embryos for future transfers.  They predicted that doing so would increase the overall success rate of IVF and make the procedure safer, more efficient and cost effective.  

One fresh IVF cycle might yield enough embryos so that in addition to performing a fresh embryo transfer in the same cycle as the stimulation and retrieval that additional embryos may be preserved for use in future cycles.  This helps to limit the exposure to certain risks confronted in a fresh cycle such as the use of injectable stimulation hormones, the egg retrieval and general anesthesia.  It also allows patients to minimize their risk for a multiple pregnancy since embryos can be divided for multiple transfers. 

At Long Island IVF, we are realizing the Jones’ dream of safer, more efficient and cost- effective IVF, as well as increasing the overall success of IVF.  

Today, an estimated 25% of all assisted reproductive technology babies worldwide are now born after freezing.  Studies performed in Sweden revealed that babies born after being frozen had at least as good obstetric outcome and malformation rates as with fresh IVF.  Slow freezing of embryos has been utilized for 25 years and data concerning infant outcome appear reassuring relative to fresh IVF.  

I personally have pushed to promote the concept of removing the financial pressure to put all your eggs in one basket by eliminating the cost of cryopreservation and storage for those patients transferring a single embryo.  Furthermore, such a patient may go through three frozen embryo transfers to conceive for the price of one at our program.  We truly believe we are practicing the most successful, safe and cost effective IVF utilizing cryopreservation.

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Was this helpful in answering your questions about cryopreservation of embryos?

 Are you aware that Long Island IVF is giving away a free basic Micro-IVF cycle, valued at $3,900.00? Check out the contest here: HURRY…it ends on August 26, 2012!!



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IVF Today: One Baby at a Time

By David Kreiner MD, and Tracey Minella

March 19th, 2012 at 10:20 pm

Single embryo transfers. Free cryopreservation, free cryo transfers, and free embryo storage. What a concept!

Back when I was doing IVF in the mid-90’s, transferring FOUR embryos was the norm! Sometimes even more, depending on the patient’s history! After a few failed IVFs, I did a GIFT/ET in 1994 with 4 eggs for the GIFT plus another 3ET. Technically, I could have been the “Septomom”, though prior history didn’t make that seem possible. I did get pregnant that cycle with twins, but later miscarried.

Also back then, my best friend was doing IVF at a clinic upstate. She had elected on medical advice to reduce a triplet pregnancy to a twin pregnancy, but miscarried after the selective reduction. A few years later, she got pregnant with triplets again. She did not reduce and, despite many complications, has generally healthy 13 year old triplets now.

It’s refreshing to see that technology at some of the finest fertility clinics now enables couples to choose single embryo transfers (SETs) and avoid the expense and potential complications that a high order, high risk multiple pregnancy brings.

Dr. Kreiner of Long Island IVF believes so strongly in the success rates and safety of SETs that the practice offers an amazing financial incentive to patients undergoing traditional IVF. Read on for details:

I entered the field of IVF in 1985 when the pregnancy rate at the Jones Institute, the most successful program in the country, was 15 percent. This rate was achieved by transferring six embryos at a time. As a consequence, we experienced many high order multiple pregnancies. Unfortunately, these were often complicated and did not always end well. Aside from pregnancy and neonatal complications, many of the marriages also suffered.

Thankfully, today IVF is so much more successful and we can attain pregnancies in greater than 60 percent of retrievals for women under 40. These rates are accomplished while transferring one, two, or at most three embryos at a time. Cryopreservation, or freezing embryos, has also improved our pregnancy rates per retrieval giving us multiple opportunities to get a patient to conceive from a single IVF stimulation and retrieval.

In an effort to encourage safer single embryo transfer and avoid risky multiple pregnancies, we introduced a program in 2007 at East Coast Fertility…and continue it at Long Island IVF today… for patients who transferred one embryo at a time. For these patients we offered free cryopreservation, storage and frozen embryo transfers until a live baby was born.

Still, patients don’t commonly choose single embryo transfer.

From our experience, similar to others’, there was no significant difference in pregnancy rates between patients who chose to transfer one embryo vs. those who chose to transfer two embryos. There was a trend, however, towards higher rates for the two-embryo transfer group that was practically eliminated when frozen embryo transfers were added. These groups were age matched with no difference except for a 40 percent twin rate and one triplet in the two-embryo transfer group compared to the single-embryo transfer group in which no twins were created.

It is hoped that these results will encourage a higher percentage of good prognosis patients to transfer a single embryo, which is the safer option.

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Would incentives and stats like those above make you consider SET for yourself? Why or why not?

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