Despite advancements, the success rates of IVF programs using frozen eggs remain inconsistent.
Cryopreservation, or egg freezing, is becoming increasingly recognized worldwide. This technique is widely chosen to preserve fertility in cases of reproductive malignancies because it is simple and relatively easy to perform. It also allows women to have autonomy over their reproductive process, enabling them to manage their personal and professional lives without being “haunted” by the natural decline in fertility that comes with age.
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Factors Affecting Pregnancy Success with Frozen Eggs
Over the past 15 years, numerous studies have examined the use of frozen eggs in IVF programs. The live birth rate associated with frozen eggs depends largely on the woman’s age at the time of freezing and the number of eggs frozen. However, the age at which pregnancy occurs does not play a significant role.
In principle, the younger a woman is, the more eggs can be retrieved for freezing, and the better their quality. Several studies have found that live birth rates can reach 50% or higher when at least 15 eggs are frozen.
Pregnancy and Live Birth Rates with Frozen Eggs
As egg freezing techniques become more widely recognized, the number of IVF cycles using frozen eggs is increasing. But is this technique truly effective? Does it provide pregnancy and live birth rates comparable to—or even better than—those achieved with fresh eggs?
Tanya Mincah tentang Promil?
Below is a summary of various studies comparing IVF success rates between fresh and frozen eggs:
In 2005, Oktay et al. published a meta-analysis of studies from 1986 to 2005 comparing IVF outcomes using fresh and frozen eggs. The results showed that fertilization rates (75.3% vs. 63.5%) and live birth rates per embryo transfer (56.8% vs. 28.4%) were significantly higher with fresh eggs than frozen eggs.
In 2010, Cobo et al. conducted a prospective study on IVF outcomes using fresh and frozen donor eggs. They found no significant difference in fertilization rates and ongoing pregnancy rates between the two groups (41.7% vs. 43.7%). That same year, Rienzi et al. reported no significant difference in embryo development outcomes from IVF/ICSI cycles using fresh or frozen eggs.
In 2014, Potdar et al. conducted a meta-analysis of 17 studies comparing IVF outcomes with frozen and fresh eggs. The results showed no significant differences in fertilization rates, embryo cleavage, or clinical pregnancy rates between the two groups. While the ongoing pregnancy rate per egg was slightly lower for frozen eggs (4.6%) than fresh eggs (5.3%), interpretation was limited due to high variability among studies.
In 2015, Doyle et al. conducted a retrospective study comparing the outcomes of autologous embryo transfer cycles using thawed frozen eggs and fresh eggs. They found fertilization rates were similar between frozen and fresh eggs (69.5% vs. 71.7%). However, implantation rates per embryo transferred (43% vs. 35%) and clinical pregnancy rates per transfer (57% vs. 44%) were significantly higher with frozen eggs compared to fresh eggs. Despite this, there was no significant difference in live birth rates/ongoing pregnancy between the frozen egg group (39%) and the fresh egg group (35%).
In 2017, Pai et al. conducted a study comparing ICSI outcomes using fresh and frozen donor eggs. Their findings showed no significant differences in fertilization rates (83.4% vs. 86.2%) or clinical pregnancy rates (60.5% vs. 63.6%). That same year, Domingues et al. reported similar results, with fertilization and pregnancy rates being roughly equivalent in both groups.
An analysis by the Society for Assisted Reproductive Technology (SART) using data from 2013–2015 reported that live birth rates were significantly higher with fresh eggs than with frozen eggs (51.1% vs. 39.7%). However, this study had limitations due to aggregated data without controlling for variables that could introduce bias.
In 2020, a study analyzing 36,925 IVF cycles found that fresh eggs had higher live birth rates than frozen eggs (47.7% vs. 39.6%).
Based on the findings above, it can generally be concluded that as IVF programs using frozen eggs continue to advance, pregnancy and live birth rates with this technique are also improving.
Is Egg Freezing a Viable Alternative for Fertility Treatment?
Although there are still debates regarding its effectiveness, existing studies recommend frozen eggs as a reasonable alternative to fresh eggs. This makes egg banking a highly feasible option.
Furthermore, compared to embryo freezing, egg freezing offers several advantages:
It avoids ethical and legal issues associated with embryo creation.
Eggs belong to an individual—unlike embryos, which involve both partners—eliminating future consent-related risks.
Egg freezing preserves a woman’s reproductive ability for later use.
The cost of egg freezing is lower than that of embryo freezing.
However, no procedure is perfect. One drawback of egg freezing is that its survival rate after freezing and thawing is lower than that of embryos. Approximately 80–90% of frozen eggs survive the process, compared to >95% for blastocyst-stage embryos.
Source:
Cobo A, Meseguer M, Remohí J, Pellicer A. Use of cryo-banked oocytes in an ovum donation programme: a prospective, randomized, controlled, clinical trial. Hum Reprod. 2010 Sep;25(9):2239-46. doi: 10.1093/humrep/deq146. Epub 2010 Jun 30. PMID: 20591872.
Eaton JL, Truong T, Li YJ, Polotsky AJ. Prevalence of a Good Perinatal Outcome With Cryopreserved Compared With Fresh Donor Oocytes. Obstet Gynecol. 2020 Mar;135(3):709-716. doi: 10.1097/AOG.0000000000003695. PMID: 32028490; PMCID: PMC7036005.
Insogna IG, Lanes A, Lee MS, Ginsburg ES, Fox JH. Association of fresh embryo transfers compared with cryopreserved-thawed embryo transfers with live birth rate among women undergoing assisted reproduction using freshly retrieved donor oocytes. Jama. 2021 Jan 12;325(2):156-63.
Kakkar P, Geary J, Stockburger T, Kaffel A, Kopeika J, El-Toukhy T. Outcomes of social egg freezing: a cohort study and a comprehensive literature review. Journal of Clinical Medicine. 2023 Jun 21;12(13):4182.
Pai HD, Baid R, Palshetkar NP, Pai A, Pai RD, Palshetkar R. Oocyte cryopreservation-current scenario and future perspectives: a narrative review. Journal of Human Reproductive Sciences. 2021 Oct 1;14(4):340-9.
Tocariu R, Niculae LE, Niculae AȘ, Carp-Velișcu A, Brătilă E. Fresh versus Frozen Embryo Transfer in In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycles: A Systematic Review and Meta-Analysis of Neonatal Outcomes. Medicina (Kaunas). 2024 Aug 22;60(8):1373. doi: 10.3390/medicina60081373. PMID: 39202656; PMCID: PMC11356234.
After graduating from the Faculty of Medicine, University of Indonesia, dr. Fiona served as a Non-Permanent Employee (PTT) doctor from the Indonesian Ministry of Health in a remote village in Luwuk-Banggai Regency, Central Sulawesi. This experience led her to continue her master's degree in International Health at Gadjah Mada University, Yogyakarta.
