The Freeze-All Cycle: A New Paradigm Shift in ART

  • Bruce S. Shapiro
  • Forest C. Garner
  • Martha Aguirre


Advantages of the freeze-all strategy were discussed by Edwards and Steptoe before the first live birth from ART. Today, there are multiple established indications for freezing all embryos in order to improve success rates or reduce maternal risks. To date, there is no indication for fresh transfer. Further reported advantages of the freeze-all strategy include generally reduced perinatal risks and reduced cost per pregnancy. The US national average success rates have increased more rapidly with thawed embryo transfers than with fresh, and national average implantation rates are now greater with thawed embryos than with fresh embryos in each autologous age group. To date, every clinical trial comparing fresh and freeze-all strategies has employed ovarian stimulation protocols that were optimized for fresh transfers. Stimulation protocols for freeze-all remain to be optimized to reduce costs and improve outcomes without concern for endometrial impact. The freeze-all strategy should further advance as new opportunities are fully explored.


In vitro fertilization Embryo cryopreservation Frozen embryo transfer Freeze-all Thawed embryos Ovarian stimulation 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Bruce S. Shapiro
    • 1
  • Forest C. Garner
    • 1
  • Martha Aguirre
    • 1
  1. 1.Fertility Center of Las VegasLas VegasUSA

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