Frozen vs. Fresh Embryo Transfer in Surrogacy: Which Is Better?
Frozen vs. fresh embryo transfer in surrogacy explained. Learn the differences, success rates, timelines, and how to choose the best embryo transfer option for your surrogacy journey.
When preparing for a surrogacy journey, intended parents often find themselves facing new medical terms, timelines, and decisions. One of the most common and important questions is whether a frozen or fresh embryo transfer is the best option. If you are researching frozen vs fresh embryo transfer, FET vs fresh transfer, or trying to understand the best embryo transfer option for surrogacy, you are not alone. This decision can feel overwhelming, especially when you want to make the best possible choice for your future child, your surrogate, and the overall success of the journey.
At Over the Rainbow, we believe knowledge brings confidence. This guide explains the differences between frozen and fresh embryo transfers, how each works in surrogacy, what current medical research says, and how fertility clinics help determine the right approach for your unique situation.
Understanding Embryo Transfer in Surrogacy
Embryo transfer is the medical step where an embryo created through in vitro fertilization (IVF) is placed into the surrogate’s uterus. This is the moment when medical preparation transitions into hopeful anticipation. In surrogacy, embryo transfer always involves a gestational carrier. The surrogate is not genetically related to the embryo. The embryo may be created using the intended parents’ genetic material, donor eggs, donor sperm, or a combination.
There are two main types of embryo transfer used in surrogacy:
Fresh embryo transfer
Frozen embryo transfer (FET)
Both are widely used and supported by reproductive medicine. The right choice depends on medical factors, timing, and clinic recommendations.The American Society for Reproductive Medicine (ASRM) provides detailed clinical guidance on embryo transfer practices and emphasizes individualized treatment plans based on patient needs.
What Is a Fresh Embryo Transfer?
A fresh embryo transfer occurs shortly after egg retrieval and fertilization. Once embryos develop, typically over three to five days, one embryo is transferred directly into the surrogate’s uterus within the same cycle.
How fresh transfer works:
Eggs are retrieved from the egg source
Eggs are fertilized in the lab
Embryos develop for several days
One embryo is transferred without freezing
Fresh transfers were once the standard approach in IVF and surrogacy before freezing technology advanced.
Potential Benefits of Fresh Embryo Transfer
Shorter time between egg retrieval and transfer
Fewer steps in the laboratory process
Can feel emotionally faster for intended parents
Potential Limitations of Fresh Embryo Transfer
Requires precise synchronization between embryo development and the surrogate’s cycle
Less flexibility if medical or scheduling issues arise
Genetic testing typically cannot be completed before transfer
Some studies suggest higher risk of ovarian stimulation effects impacting uterine receptivity
According to research summarized by the Society for Assisted Reproductive Technology (SART), clinics now use fresh transfers more selectively, given advancements in frozen transfer outcomes.
What Is a Frozen Embryo Transfer (FET)?
A frozen embryo transfer involves freezing embryos after fertilization and transferring them during a later cycle. The embryos are preserved using advanced cryopreservation techniques known as vitrification. In surrogacy today, FET is the most commonly recommended approach.
How frozen transfer works
Embryos are created through IVF
Embryos are frozen and stored
Genetic testing may be performed
The surrogate’s uterus is prepared in a separate cycle
One embryo is thawed and transferred
The Mayo Clinic explains that modern freezing techniques have made frozen embryo transfers highly effective and reliable.
Benefits of Frozen Embryo Transfer in Surrogacy
Frozen embryo transfer offers several advantages that align well with the surrogacy process.
Greater scheduling flexibility
FET allows medical, legal, and logistical steps to occur without pressure. Contracts can be completed, insurance finalized, and cycles planned calmly and intentionally.
Improved uterine preparation
The surrogate’s body can be fully prepared for implantation without the effects of ovarian stimulation medications.
Ability to perform genetic testing
Preimplantation genetic testing (PGT) requires embryos to be frozen. This testing helps identify chromosomally normal embryos, which may improve implantation rates.
Strong success rates
Multiple studies reviewed by the National Institutes of Health (NIH) indicate that frozen embryo transfers often show equal or improved pregnancy outcomes compared to fresh transfers in many cases.
Reduced medical stress on the surrogate
Because the surrogate is not undergoing egg retrieval, FET allows for a smoother, more controlled medical experience.
Success Rates: Frozen vs Fresh Embryo Transfer
One of the most common questions intended parents ask is whether one option is more successful than the other.
While success rates vary based on embryo quality, clinic protocols, and patient factors, current data suggest:
Frozen embryo transfer success rates are comparable to or higher than fresh transfers in many populations
Frozen transfers may reduce the risk of certain pregnancy complications
Clinics increasingly prefer FET due to consistency and predictability
The Centers for Disease Control and Prevention (CDC) tracks IVF outcomes across the United States and shows a growing shift toward frozen embryo transfers in assisted reproduction.
It is important to note that no transfer method guarantees success. Your fertility clinic will evaluate your specific situation to recommend the best approach.
Which Option Is Better for Surrogacy?
In most surrogacy journeys today, frozen embryo transfer is the preferred option. This is not because fresh transfer is ineffective, but because surrogacy involves additional layers of coordination.
FET works well with surrogacy because it allows:
Time for legal contracts
Careful medical screening
Emotional preparation for all parties
Flexibility across state lines
At Over the Rainbow, the majority of intended parents move forward with frozen embryo transfers under the guidance of their fertility clinic.
Medical and Emotional Considerations
Beyond statistics and protocols, it is important to consider the emotional experience of the journey.
Frozen transfers often allow:
Reduced pressure on timing
More predictable schedules
Fewer last-minute changes
Greater peace of mind for intended parents and surrogates
Fresh transfers can feel faster emotionally, but they also require precision and flexibility that not all journeys allow. We work closely with fertility clinics to help intended parents understand these nuances and feel supported in whichever option is recommended.
How Over the Rainbow Supports Embryo Transfer Decisions
Choosing between frozen and fresh embryo transfer is not something you have to decide alone.
Over the Rainbow:
Coordinates with your fertility clinic
Helps align medical timing with legal steps
Supports surrogate preparation and education
Communicates clearly at every milestone
Ensures expectations are aligned before transfer
Our role is to help everything come together smoothly so the focus stays where it belongs: on growing your family.
Frequently Asked Questions
Is frozen embryo transfer safer than fresh transfer?
Both are considered safe. Frozen transfers may reduce certain risks and allow for better uterine preparation, which is why they are commonly used in surrogacy.
Does frozen embryo transfer take longer?
FET may add time upfront, but it often creates a smoother overall timeline by allowing legal and medical steps to align without pressure.
Can you choose fresh or frozen transfer?
The final recommendation comes from your fertility clinic based on medical factors. Intended parents are involved in the decision-making process.
Are frozen embryos as healthy as fresh embryos?
Yes. With modern vitrification, frozen embryos have excellent survival and implantation rates.
Is one option more expensive?
Frozen transfers may include additional storage and thawing fees, but costs vary by clinic and protocol.
Ready to Start Your Journey?
Deciding between frozen vs fresh embryo transfer is an important step in the surrogacy journey, but it does not need to feel overwhelming. Both options are medically sound, and your fertility clinic will guide the recommendation based on what offers the best chance of success for your specific circumstances.
At Over the Rainbow, we believe surrogacy works best when decisions are thoughtful, informed, and supported with care. Our team is here to guide you through every stage of the process, from early planning to embryo transfer and beyond.
If you are considering surrogacy or preparing for embryo transfer, we invite you to connect with Over the Rainbow. Let us help you move forward with confidence, clarity, and support.