I am Dr. Mukesh Agrawal. I have over 30 years of experience. Today I will discuss the concept of all freeze techniques. There has been a lot of interest generated recently after the advent of verification for the all freeze technique in IVF. When we manage infertility patients and we take them up for IVF, we usually look at their age, hormones and their internal follicles count. Now with this, we divide patients into 3 categories which are normal responders, poor responders, and hyper-responders. The normal responders are those that after injection they will produce not more than 10 eggs. Poor responders are the patient who will not produce not more than 3-4 eggs after giving conventional drugs. And then hyper-responders are the patients who are usually the PCOD patient. After giving injections, they will produce lots of eggs and they are difficult to manage.
They can go at the risk of ovarian hyperstimulation syndrome. So, this all freeze technique we usually reserve for the patient who is likely to produce more than 10 eggs or those who are at the risk of hyperstimulation syndrome or for the patients who have thin endometrium. Now for these patients, we should do ovarian stimulation, take out the eggs, after doing the fertilization with the husband sperm then we culture the embryo up to the blastocyst stage. Once the blastocyst is formed, they are frozen with the vitrification technique. And in the following cycle, the patient's endometrium is prepared by giving estrogen tablets and once the endometrium reaches thickness more than 7 mm and its blood flow is good. That is the time we decide when we can decide when to add the progesterone injections and we can decide the day for embryo transfer. Now with all this proper selection of the patient, proper use of all freeze technique in selected cases we are able to give results in more than 80-90% of the patients.
And friends, here I would like to tell you that all freeze technique for every patient is absolutely not recommended. For not responding to patients, if you do fresh transfers, their results are 5% more than the frozen transfer. And for the other 2 categories where we can do pulling and create an embryo in 2 cycles. So, you have more than 2 or 3 embryos. And then you can select good embryo to transfer to give better result in poor responders. In PCOD patients you have a freezing technique to avoid the risk of OHSS. Because ultimately the aim is to avoid any complications. IVF procedure should be very safe, effective and take home baby rate should be high.
Wish you Good Luck!