Natural Cycle IVF
Last updated date: 18-Aug-2023
Originally Written in English
Natural Cycle IVF
What is Natural Cycle IVF?
There are several ways for treating infertility. Personal concerns, medical issues, and, of course, financial status all play important roles. Every month, your ovary produces a mature egg. When an egg is fertilized naturally, it develops into an embryo and adheres to the uterine wall. Traditional IVF employs injectable hormones to stimulate your body to generate multiple eggs at once. More eggs equal more chances for viable embryos.
To understand in vitro fertilization, one must first comprehend the natural conception process. An egg is discharged from the ovary into the fallopian tube in the middle of a regular menstrual cycle. Fertilization takes place in the fallopian tube, where the fertilized egg spends many days dividing and developing into an early embryo. The embryo enters the uterus and implants in the uterine wall a few days later.
In vitro fertilization can be viewed as a fallopian tube bypass. In order to produce many eggs, the ovaries are stimulated with injectable fertility medications. During this period, transvaginal ultrasounds and blood tests assist establish whether the eggs are developed. At this stage, they are extracted through the vagina using a simple process that only requires light anesthesia. The eggs are placed in a petri dish and exposed to the sperm of the partner.
The eggs are checked the next day to see if fertilization was effective. If this is the case, they are left in the petri dish to divide and develop into early embryos. After a few days, one or more embryos are implanted in the woman's womb in a straightforward process that is no more painful than a Pap test. IVF laboratory technicians evaluate extra embryos. If they are viable, the family may ask to freeze them for future use.
In vitro fertilization (IVF) is an advanced reproductive technology (ART) that was first used successfully in the United Kingdom in 1978. IVF was first used primarily to treat infertility caused by blocked fallopian tubes.
IVF has grown into an effective treatment for all reasons of infertility when simpler therapies have failed or are not an option. IVF success rates have also improved significantly over the previous several decades. In reality, several clinics are already achieving IVF success rates of 50% or more for patients with a good prognosis.
For many patients, traditional IVF is required. It uses medications to extract numerous eggs and embryos in order to boost your chances of becoming pregnant. No stimulating medicines are used in Natural Cycle IVF. Women who do not respond well to fertility medicine or have a low ovarian reserve may benefit from Natural Cycle. Regardless of stimulation drugs, such women do not generate more than one natural egg each month. During a Natural Cycle, the body's single natural egg is collected, injected with sperm, and the embryo is transported to the uterus if fertilized. During a Natural Cycle, no stimulant medicine is provided.
Many women choose Natural Cycle IVF to reduce the cost and pain during ovarian stimulation. In certain circumstances, the outcome of Natural Cycle IVF is estimated to be the same as that of stimulated IVF, in which case doctors would recommend it as the therapy of choice.
How natural cycle IVF is done?
Your body spontaneously chooses the healthiest egg. The egg is extracted when it is mature, which is normally around the tenth day of your cycle. The technique for collecting eggs is simple. It takes less than 5 minutes to remove the egg from a single follicle. Many patients are able to return to work the same day after completing the surgery without the need for anesthesia or pain management medication.
Using modern laboratory technology, your egg is fertilized with your partner's or donor's sperm. During the embryo transfer operation, a single embryo is transplanted into the uterus two to three days later. doctor checks for pregnancy two weeks later. The complete procedure takes 10-14 days and is dependent on your menstrual cycle. You take no or little medications and have a very low risk of multiple pregnancies.
Except for the hCG trigger injection, which is needed to guarantee ovulation occurs within the specified period of the Egg Retrieval, no medication is used in most situations. The following steps take place over a period of 15 to 20 days:
- Ovarian Monitoring:
On Day 3 or 4 of the Menstrual Cycle, ultrasonography and blood tests are used to get a diagnosis. Follicular growth is tracked over the following 6 to 9 days as the follicle matures into an egg.
An hCG "trigger" injection is administered 36 to 40 hours before the planned Egg Retrieval (also known as Ovum Pick-Up (OPU) to encourage egg maturation within a timeframe.
- Egg Retrieval (OPU):
During a brief anesthesia process, the egg is extracted with a tiny ultrasound-guided needle.
- Sperm Collection And ICSI:
A semen sample is obtained on the day of egg retrieval in order to fertilize the recovered egg. Intracytoplasmic sperm injection (ICSI) involves injecting a single sperm into the egg using a precise needle to boost the odds of conception. If the egg is fertilized successfully, the embryo transfer will take place 3 to 5 days later.
- Embryo Transfer (ET):
The Embryo Transfer process is non-invasive and does not require sedation. After the procedure, blood tests are used to confirm pregnancy by measuring hormone levels.
What happens after the embryo transfer?
After the embryos have been placed into the womb, you should wait around 2 weeks before taking a pregnancy test to discover if the procedure was successful. Some clinics may advise you to do a standard urine pregnancy test at home and report the results, whilst others may need you to come into the clinic for a more reliable blood test.
The worry of not knowing if the therapy has succeeded can make this 2-week wait quite stressful. It might be the most difficult component of the therapy process for some people. During this time, make sure you get enough rest and support.
During this time, you may find it helpful to speak with a therapist at the fertility clinic or to contact other individuals who are going through your situation. If you do get pregnant, ultrasound scans will be performed in the following weeks to ensure that everything is proceeding as predicted. You will then be offered the same prenatal care that all pregnant women get.
Unfortunately, IVF is unsuccessful in many cases and you should try to prepare yourself for this possibility. If therapy does not work, you may be able to try again, but you should not hurry into it. During this tough period, you may find that counseling or fertility support groups might be beneficial.
What are the Advantages of Natural Cycle IVF?
There are several advantages to utilizing Natural IVF as a therapy for infertility. Eligible candidates can look forward to the following benefits:
- Natural IVF lowers the risk of difficulties and negative effects associated with fertility medicines. Ovarian Hyper-Stimulation Syndrome (OHSS) is one of these adverse effects, which can be exceedingly painful and pose a danger to future fertility. Due to developments in IVF cycle management and drugs to avoid this issue, this is a relatively rare complication, but a natural cycle eliminates such a danger.
- Your process will take significantly less time than traditional IVF and can be performed under local anesthetic, however ladies will feel more comfortable and pain-free if they are sedated for 10 minutes. Anesthesia, often in the form of intravenous sedation, is required for standard IVF egg retrieval for 20-30 minutes.
- Natural IVF is a suitable choice for some people, but not all. Only one high-quality egg is required. The objective is to have a healthy egg/embryo/baby.
Who are the Best Candidates for Natural Cycle IVF?
Natural IVF is a possibility for certain infertile individuals. Those who would benefit from this natural alternative include:
- Women in their twenties with severe fallopian tube disease and no other problems.
- Women in their twenties who have minor male factor infertility and no other problems.
- Women over the age of 40 who have failed several IVF rounds, have a diminished ovarian reserve, have produced 1-2 eggs with traditional IVF, or have a very increased FSH (follicle stimulating hormone) or a very low AMH (Anti-Mullerian Hormone) value.
How natural cycle IVF differs from traditional IVF?
A single egg develops and matures inside an ovarian follicle during a typical monthly reproductive cycle. When a woman's hormones reach a specific level, the mature egg is released and ready for fertilization. A woman takes drugs for 9 to 12 days during a stimulated IVF cycle to stimulate both of her ovaries to generate and mature numerous egg follicles. During the stimulation phase, a doctor will use ultrasounds and blood tests to track the growth of the follicles until they reach a specified size.
A physician will next perform an egg retrieval operation under anesthesia to retrieve the eggs from the follicles. They are then fertilized in the lab, where the embryos will develop until an embryologist can select the best one(s) for transfer back into the woman's uterus. Any high-quality embryos that are not transplanted can be preserved for future use.
Due to the lack of drugs used to stimulate the ovaries in natural cycle IVF, the cycle can only generate one mature egg at a time. Ultrasounds and blood tests are used to follow the growth of the single ovarian follicle so that it is not discharged (ovulated) by the body before it can be retrieved.
The patient is subsequently subjected to the same sort of egg extraction procedure as in a stimulated IVF cycle in order to recover the egg from the solitary follicle. If the egg retrieval is successful, an effort is undertaken in the laboratory to fertilize the egg. If a viable embryo develops, it will be returned to the uterus by a doctor.
Natural cycle IVF and conventional IVF cycles are fairly comparable in terms of schedule and techniques. The only difference is that in a natural IVF cycle, the patient does not employ medicines to induce multiple egg production.
Before deciding on a therapy, thoroughly evaluate claims, especially if a facility claims that a certain treatment strategy is less stressful, less expensive, and less hazardous. Ask about how the treatment succeeds on your most crucial criterion, childbirth.
What is the success rate of Natural Cycle IVF?
Traditional IVF cycles have much greater pregnancy and live birth rates than natural cycle IVF. In reality, three to four natural cycles may be required to obtain a successful pregnancy, as opposed to one stimulated IVF cycle. The recovery of many viable eggs is a key factor that impacts this success rate.
The major explanation natural cycle IVF success rates are so low is that without drugs, there is a considerably larger likelihood of a cycle being canceled at each stage. Many patients will ovulate early, or an egg will not be recovered at the moment of egg retrieval. Many others will experience a cycle that does not result in fertilization, and so no embryo.
The consequent delivery rate per started cycle is low for women 37 and younger, and very low for women over 40. The pregnancy rate is similar to that of intrauterine insemination (IUI); however, IUI is substantially less expensive and does not require a surgical operation. On average, IUI success rates are around 15% for women under the age of 37 and 5–10% for women over the age of 40.
What are the risks of Natural Cycle IVF?
One complication that individuals undergoing natural cycle IVF do not face is ovarian stimulation with drugs. It's known as ovarian hyperstimulation. When a woman's body overreacts to drugs, this is known as ovarian hyperstimulation. This might result in fluid buildup in the abdomen and pelvis. In rare but severe situations, the illness might progress to more serious problems such as blood clots. Mild episodes of ovarian hyperstimulation usually settle on their own. In more extreme situations, the extra fluid can be removed by a doctor during outpatient treatment.
Natural cycle supporters because just one embryo is transferred into the uterus every cycle, IVF patients avoid the chance of multiples (twins and triplets). While a single embryo may divide into two on its own, transferring one embryo at a time is the most effective strategy to avoid high-risk multiple pregnancies.
Some disadvantages of natural cycle IVF include:
- The single egg may not be viable for fertilization or mature into a healthy embryo, necessitating numerous Natural IVF rounds, greater costs, and problems.
- Furthermore, because you would have only generated one egg for retrieval and fertilization, you will not be able to store any extra resultant embryos that you would have had if you had used a standard stimulated IVF procedure.
- Because there will only be one embryo, there will be no possibility to select the best embryo.
- Multiple cycles and punctures through the vaginal wall and into the ovaries may be required. Because of many cycles, the needle puncture sites may become vulnerable to bleeding in subsequent egg retrievals.
- Natural cycles have lower pregnancy rates as compared to conventional IVF whether the egg reserve is good or somewhat low. Pregnancy rates are comparable among women who have a very low egg reserve.
Emotional stress associated with Natural Cycle IVF
Natural cycle IVF providers argue that it is less stressful because it does not require as many injectable drugs. While it is true that not having to handle the drugs alleviates some of the burdens, you must still attend all of the morning monitoring appointments that a patient receiving injections must. You must also go through the egg retrieval process, which many patients believe to be the most difficult aspect of the process.
Many would say that the stress level with natural cycle IVF is higher because the cycle is more likely to be canceled. You must be concerned about early ovulation and the potential that there may be no egg to recover.
Should I Consider Natural Cycle IVF?
When there are multiple treatment choices to consider, making a selection can be challenging. Patients must assess the most essential aspects for them and discuss their concerns with their medical care team. It is recommended that patients ask the following questions while deciding on a treatment option:
- What is your program's delivery rate for each initiated cycle?
- How many cycles will I have to go through to deliver a healthy baby?
- How much will they cost?
- Will I be able to store any embryos for future pregnancies as I get older?
- Are you advising this because you believe I am unsuitable for conventional IVF?
Discuss the advantages and disadvantages of natural cycle IVF vs standard IVF with your doctor then, the option will become obvious. It is advisable to consider the big picture. Remember that your ultimate objective is to have a kid. If you must use IVF, a classical IVF cycle is without a doubt the most successful and efficient procedure available. It provides you with the highest opportunity of completing your task in the lowest period of time.
What is the Cost difference between Natural Cycle and Traditional IVF?
While it is obvious that natural cycle IVF costs less than normal IVF since fewer medicines are used, it is crucial to understand when comparing prices that the option is clear from a value standpoint.
Traditional IVF cycles provide a considerably higher probability of pregnancy and live birth for the money spent than natural cycle IVF. In fact, your odds are greater with one stimulated IVF cycle than with three or four normal cycle IVF cycles. When you consider the option of having frozen embryos accessible at the end of a standard IVF cycle, the value increases even more.
Medications might be expensive, but they are not the most expensive aspect of an IVF cycle. The most expensive aspects of an IVF cycle are the monitoring, egg retrieval, and laboratory fees. Maintaining a best embryology facility with cutting-edge technology and highly qualified staff is expensive, but it is vital to the success of IVF. Whether or not your IVF cycle is stimulated, you will still rely primarily on the embryology lab's work.
An egg is released from the ovary into the fallopian tube during a normal menstrual cycle. The fertilized egg divides and develops into an early embryo in the fallopian tube. The embryo reaches the uterus and implants in the uterine wall after a few days. Many women prefer Natural Cycle IVF to avoid the costs and pain of ovarian stimulation. When the final result of Natural Cycle IVF is expected to be comparable to that of stimulated IVF, doctors will recommend it as the preferred option.
Your body chooses the healthiest egg for you. The egg is retrieved when it is mature, which is usually around the tenth day of your cycle. Then the egg is fertilized with your partner's or donor's sperm. Two to three days later, a single embryo is transferred into the uterus. a pregnancy test is performed two weeks later to check whether the pregnancy was achieved or not. The anxiety of not knowing whether or not the therapy was successful might make the two weeks following embryo transfer difficult. It may be the most difficult component of the therapy process.
Traditional IVF cycles produce far more pregnancies and live births than natural cycle IVF. In reality, three to four natural cycles may be required rather than one augmented IVF cycle to have a successful pregnancy. One concern that individuals undergoing natural cycle IVF do not face is ovarian stimulation with drugs. Transferring one embryo at a time is the most successful approach for minimizing high-risk multiple pregnancies.
It may be tough to make a decision when there are multiple therapy alternatives to consider. Patients must highlight their most essential problems and convey them to their medical care provider.