PURPOSE To determine the pregnancy rate following the exclusive transfer of twice frozen twice thawed embryos. MATERIALS AND METHODS All day 3 transfers of exclusive twice frozen-twice thawed embryos were retrospectively identified over a 13-year time-period. The cryopreservation technique used a simplified slow cool freezing protocol. Embryos could have been originally cryopreserved at the 2 pronuclear or multi-cell stage. RESULTS Survival rates were 83.3%. The live delivered pregnancy rate was 18.1% (15/83). The implantation rate was 13.1% (22/168). CONCLUSIONS These data suggest that twice frozen twice thawed embryos should not be discarded but either transferred alone if they are the only embryos left, or mixed with frozen embryos that have never been thawed. Though the live delivered pregnancy rates are inferior to fresh embryo transfer the marked reduction in cost and avoidance of the risk of ovarian hyperstimulation justifies their transfer.