Natural cycle IVF Process:
Natural cycle is most suitable for women having regular menstrual cycles and when the ovaries produce an egg every month. Natural cycle IVF is a type of IVF treatment whereby we aim to retrieve the egg that one’s body has selected.
In Natural Cycle IVF no gonadotropins are used which means no hormone injections are given to facilitate or stimulate ovaries and grow a number of eggs.
However, the regular and frequent appointments with Fertility Specialists, along with some injections to trigger ovulation and surgical harvestings of eggs as well as developing embryo in the lab are all there in the natural cycle IVF.
In the early days of IVF, natural cycle as a technique was used. But the natural cycle IVF does not prove beneficial in routine IVF patients. However, some women with poor ovarian reserve opt for this process to keep the cost minimal and also to have a reasonable chance of success.
Who are candidates for natural cycle IVF?
In natural cycle IVF, there are no ovarian stimulating drugs used, unlike the conventional IVF treatment. It is usually used for women where medication is unlikely to help in recruiting a higher number of eggs (clinically known as a ‘suboptimal ovarian reserve’ or those with a previous suboptimal response to ovarian stimulation ‘poor responders’).
How is natural cycle IVF done?
In standard IVF, fertility drugs are given to stimulate the production of multiple eggs. In the natural cycle IVF no fertility medications are given for follicle growth. However, to prevent premature ovulation prior to egg collection, a medication called antagonist is given once the follicle reaches 14 mm and egg maturation is triggered using HCG injection and egg collection planned 34 hours later (modified natural cycle).
As natural cycle, IVF follows the normal menstrual cycle during which usually only one egg is obtained. The entire process takes 15 days during which time the woman is monitored to track the development of her follicles, using ultrasound scans and blood tests.
There is quite a high cancellation rate (approximately 30%) due to either high hormonal levels at the start of a cycle or arrest in follicular growth. The egg collection is usually done using light sedation. Ultrasound-guided follicular aspiration is done. In the aspirate of the follicle, the embryologist should be able to identify the egg. The chance of retrieval of an egg is only around 50%. Once an egg is obtained, fertilisation is achieved using IVF or ICSI technique.
The resulting embryo is cultured in the lab and transferred back into the woman’s uterus.