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Natural Cycle IVF And Mild IVF

Natural Cycle IVF

The decision to start fertility treatment is perplexing. There are many personal, medical and financial factors that play key roles in your decision. At the end of the day, the decision lies with you, the patient, to decide what’s best for you.

Mild and natural cycle IVF are different in their approaches to fertility and to conventional IVF.  The focus of these procedures is working alongside your natural menstrual cycle instead of using stimulating drugs to spur on immature egg cells.

Natural Cycle IVF And Mild IVF - All You Need To Know

It's important to know that there are IVF treatment options out there that not only use lower doses of drugs and are therefore not only better for women undergoing IVF, but are also more affordable per cycle. When it comes to choosing your treatment, a little bit of knowledge as to the various options can go a long way in protecting your health and reducing the cost of treatment.

Here is our guide to getting know the gentler and safer IVF options available.

1. What is Natural Cycle IVF?

Natural cycle IVF involves retrieving the eggs with your menstrual cycle. The aim is to collect egg that has been naturally selected and grown by your body. That chosen egg will then be the egg that becomes fertilised and placed back in the womb when ready.

With this treatment, the focus is on the quality of the egg instead of the quantity. Fewer fertility drugs are used too.

2. What is the Process of Natural Cycle IVF?

Before you begin the natural cycle IVF, you will have to consult your physician. In these consultations, they will carry out scans, bloodwork and general monitoring to determine which treatment is best for your fertility. From there, your doctor will begin the process of natural cycle IVF.

During a normal monthly menstrual cycle, a single egg grows and matures within the ovarian follicle. This egg will be released once it’s matured and your hormones have reached a certain level.

When the egg is ripe for retrieval, your doctor will retrieve the egg through a simple surgery. Since this procedure is free from fertility medications, you will have to be closely monitored with ultrasounds and bloodwork. Your doctor uses these tools to find the best time to start the retrieval process.

Once the initial consultations, scans and blood tests are underway, your doctor will start the egg collection procedure. This procedure is performed under sedation in the theatre. It usually takes approximately 45 minutes to complete the egg collection.

From the egg collection, the embryo is then transferred back into the womb. Once the egg is fertilised, it becomes an embryo. The embryo transfer is a quick and simple procedure that doesn’t need any sedation.

The last step of the natural cycle IVF process is the pregnancy test. A positive pregnancy test will determine if the process was successful or not.

3. What are the Benefits?

Besides the lack of extra fertility medication and invasive procedures, the natural cycle IVF process has many benefits. These include:

  • Higher quality eggs: As the egg is naturally selected by the body, it can be of a higher quality than an egg that is produced through stimulated IVF.
  • More affordable: Without costly medication, natural cycle IVF is less expensive than stimulated IVF.
  • No or minimal fertility drugs: enjoy the benefits of IVF without the altering added hormones in your body. Drug side effects are unpleasant and taking injections can be daunting.

4. What Are the Risks?

While the process is mostly natural with little medication usage, there are some risks involved with the procedure.

  • Premature ovulation: As natural cycle IVF is not controlled by fertility drugs, it does become harder to pinpoint that crucial moment of ovulation. This window can easily be missed with premature ovulation and therefore your doctor won’t be able to retrieve the egg. You will have to wait until your next cycle to try the egg retrieval again.
  • The egg may not develop fully: Previously, we mentioned that natural cycle IVF focuses on the retrieval of one egg per cycle. This means that there’s only one egg to use. If the egg is unsuitable, you don’t have the option to fall back on an alternative it does not grow into a healthy embryo.
  • Lower live birth rates per cycle: One of the main risks of going through natural cycle IVF is taking on the possibility of it being unsuccessful. SCRC noted that success rates can be as low as 7% per cycle.

5. Who is Natural Cycle IVF Best For?

Luckily, in order to be a candidate for natural cycle IVF, the boundaries are pretty open. Natural Cycle IVF is best for women who:

  • Are younger than 45
  • Have regular menstrual cycles
  • Don’t have hydrosalpinx
  • Have a normal uterus

This fertility treatment is especially key for women who suffer from:

  • A low ovarian reserve
  • Poor responses to stimulation or conventional IVF
  • Endometriosis
  • Pelvic adhesions which cause tubal blockages
  • A family history of oestrogen dependent tumours or ovarian cancer and want to avoid the high doses of drugs given in conventional IVF

6. What Are the Success Rates?

Considering the choice between different fertility treatment lies mainly on the success rates. Natural cycle IVF is concerning due to the lower success rates that result in multiple treatment cycles. City Fertility found that it will take several treatment cycles to achieve the same results as you would experience with a single treatment of stimulated IVF.

Medical reports show that the clinical pregnancy rates are currently ranging from 15-25% per embryo transfer.

It is important to note that the success rates are low due to the lack of medication use. Without medication, there is a higher chance of a cycle being cancelled at each stage, as per SGF’s findings. Premature ovulation can disrupt the retrieval procedure. Taking hormone control medication will keep your cycle on track and allow for strict ovulation periods.

7. What is Mild IVF?

Also carried out during the natural menstrual cycle, Mild Stimulation IVF uses minimal doses of fertility drugs in order to achieve a mild response to stimulation. Compared to the 4-5 weeks of medication used in conventional IVF, stimulating medication is given for just 5-9 days, meaning it is a much shorter process and much gentler on the body than traditional IVF.

This treatment uses a gentler stimulation to work with the body’s menstrual cycle. The aim is to collect higher quality eggs while taking lower doses of drugs.

If you had to compare traditional IVF cycles with mild IVF cycles, the use of stimulating medication decreases. In traditional IVF, you can expect to inject 125 - 450 daily units of FSH. Whereas with mild IVF, the FSH injections drop to 75 - 150 units daily.

This medicated process helps achieve the goal of growing fewer but better quality eggs.

8. What is the Process of Mild IVF?

With any fertility treatment, it all starts with an initial consultation and scan. Your fertility specialist will assess your body’s capability of producing eggs and falling pregnant. They will then give you a personalised treatment plan based on your needs and preferences.

You can discuss your fertility treatment options with your doctor. From there, they will talk through the treatment plan and what you can expect with the scans, treatments, and procedures. Before starting your process of Mild IVF, you will be required to take at least one round of birth control in order to regulate your cycle.

After a scan, your doctor will prescribe ovulation boosting medication. This encourages your body to produce more eggs for the procedure. For your eggs to be collected, they have to be mature. When matured, your doctor will administer an hCG injection.

Finally, the IVF retrieval process will begin. Your eggs will be retrieved through surgery where they will then be fertilised. The fertilised embryo is then transferred into your womb for impregnation.

9. What are the Benefits?

Minimal stimulation IVF offers a fantastic alternative to traditional IVF. Some of the benefits include:

  • You are required to take less medication:Treatments are kinder to the body and there is a reduced chance of potential side effects. Your doctor may recommend a round of birth control to regulate your cycle. From there hCG injections will be administered. Despite these medications, it’s still considerably less than what you’d expect to take with traditional IVF.
  • You don’t have to commit too much time: Mild IVF works with your natural cycle and won’t have you limited to a strict time period. You are able to choose when it’s right for you to begin or repeat the process.
  • It will cost you less: Only a few, if any, fertility medications will be required. This makes your costs a lot less than what you would experience with traditional IVF.
  • More patient-friendly: Treatment is carried out within a woman's natural menstrual cycle and there is no artificial menopause. This means that treatment is more patient-friendly, with less physical and emotional stresses and side-effects
10. What are the Risks?

Like natural cycle IVF, there is a much high risk compared to conventional IVF. As your natural menstrual cycle controls when your eggs can be retrieved, you are more susceptible to disruptions.

  • Low egg retrieval rates:  Your doctor may be able to only get 2-4 eggs for fertilisation per cycle. There is also the risk that no eggs will be retrieved at all.
  • IVF cycles can easily be cancelled: Due to premature ovulation, your planned IVF can  be cancelled if the ovulation cycle doesn’t sync up to your doctor’s retrieval requirements.
  • Fewer eggs to freeze: With conventional IVF, you have the option to freeze multiple eggs for future use. However, mild IVF limits this option as only a few eggs are retrieved.

Mild IVF cycles may not be for everyone. It’s always best to consult your physician to discuss your fertility history and to choose the best treatment for you.

11. Who is Mild IVF Best For?

There are many couples who are eager to try mild IVF because of the reduced costs, side effects and time commitments. Mild IVF could the right fertility treatment for you if you:

  • Are under 35 years old
  • Battle with tubal factor infertility
  • Have a male partner with infertility
  • Find that the traditional IVF injections aren’t for you
  • Have a diminished ovarian reserve
  • Have endometriosis or Polycystic Ovaries/ Polycystic Ovarian Syndrome
12. What Are the Success Rates?

When it comes to mild IVF you have to consider the success rates and understand the critiques of the treatment. With fewer eggs being retrieved, there is less of a chance of the treatment being successful. Keep in mind that the success rates are also largely dependant on your body and your level of fertility. According to Your IVF Journey, there are some encouraging signs of success in mild IVF. On average, 3 eggs are retrieved during the egg collection process. In comparison, traditional IVF collects 9 eggs.

As there are only a ⅓ of eggs collected compared to traditional IVF, you can expect to see a decrease in success rates. With traditional IVF, the success rates are averaged to 71.7% for standard cycles. On the other hand, the chances of falling pregnant with mild IVF are 36.1%.

As mentioned, your body’s ability to produce quality eggs and to carry out a pregnancy largely alters the success rates.

13. What are the Costs?

Most couples opt for natural or mild IVF treatments due to the cheaper costs. Unfortunately, NHS insurance won’t cover the treatments due to the low success rates.

Luckily, natural IVF is around half the price of traditional IVF. This makes it more affordable for patients to pay out of their own pocket. It also makes it more affordable to do multiple cycles to boost your chances of falling pregnant.

You can expect to pay around £2,000 to 3,000 a cycle for natural or mild IVF. Compared to an average of  £5,000 for traditional IVF, it’s a more cost-effective option.

 

Like any fertility treatment, it’s recommended that you discuss with your fertility doctor what’s best for you. They will be able to work with your budget, body, and fertility needs in order to provide the best treatment.

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Article By

Dr Beverley (MBChB, MRCGP) is a qualified GP. She works in a GP practice in Manchester and also helps in the out of hours GP service. She has experience in both obstetrics & gynaecology and paediatrics and has three children of her own.

to read more articles by Dr Beverley Sanders

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