Wednesday 24 February 2010

What is Natural or Mild IVF?


Natural cycle IVF is suitable for all women who ovulate naturally. Young women who want to avoid stimulating hormone injections can try natural cycle IVF first. It has been particularly effective in older women and in those who have responded poorly to stimulating drugs. It can also be suitable for women who want to avoid ovarian stimulation or fertility drugs as a matter of choice, and indeed for those for whom there may be no other choice, such as women at risk of hormone-related cancers. It is also safer and healthier for women than a fully stimulated cycle. The total cost is significantly less than for stimulated IVF. There is no suppression of the ovaries and associated menopausal symptoms and the treatment cycle is completed within a woman’s own menstrual cycle.

The consultants at Create Health Clinic have published extensively in this field and have contributed in making Natural cycle IVF more successful. The centre puts women’s health and safety at the top of the agenda when it comes to assisted conception, physically, emotionally and financially.

WHAT IS NATURAL CYCLE IVF?
Put simply it is IVF without the use of stimulating drugs. In stimulated IVF/ICSI cycles the patient takes drugs to stimulate her ovaries to produce multiple eggs. With natural cycle IVF the treatment cycle relies on the spontaneous development of one follicle only and therefore the aspiration of only one egg from the follicle (it is possible however that the cycle can have more than one egg or no eggs). There is nothing new about natural cycle IVF, in fact Louise Brown, the world’s first ‘test-tube’ baby was conceived using this method 25 years ago.

DOES THIS MEAN NO STIMULATING DRUGS ARE TAKEN WITH NATURAL CYCLE IVF?
Yes. But drugs may be given to prevent spontaneous ovulation. This is called a Controlled Natural Cycle. In addition the patient will need to take hCG (as with other less invasive treatments such as Ovulation Monitoring and Intra-Uterine Insemination) to time egg collection as well as progesterone pessaries to supplement the body’s progesterone levels.

WHAT ARE THE BENEFITS OF NATURAL CYCLE IVF?
There are no side-effects such as ovarian hyperstimulation syndrome (OHSS), bloating, mood changes or other concerns relating to ovarian stimulation. Due to the effect of ovarian stimulation drugs on the body, patients undergoing stimulation cannot pursue consecutive cycles of treatment and need to take 2-3 months break between treatment cycles. In contrast, natural cycle patients can repeat their treatment in consecutive cycles. As only one embryo is transferred in a natural cycle, there is virtually no risk of a multiple pregnancy. Furthermore, ovarian stimulation drugs are expensive and this means that the cost of natural cycles is significantly less compared to the cost of stimulated cycles reducing costs by up to £1500 per cycle.

WHAT ARE THE DISADVANTAGES OF NATURAL CYCLE IVF?
The success rate per cycle is low compared to stimulated IVF. There is also a small risk of spontaneous ovulation before egg collection.

WHO CAN HAVE NATURAL CYCLE IVF?
Women under the age of 45 who ovulate regularly can be considered for natural cycle IVF. Natural cycle ICSI is also offered, although patients should be informed that natural cycle ICSI success rates are lower than natural cycle IVF.

WHO CAN’T HAVE NATURAL CYCLE IVF?
Natural cycle IVF is not suitable for those who do not ovulate spontaneously. Instead they will need a Mild Stimulation option.

WHAT IS MILD IVF?
It is aimed at producing 2-7 eggs. It does not involve shutting down the hormones for 2 weeks. It is conducted in the woman’s natural menstrual cycle. Smaller dosages of stimulating drugs are given for a shorter period to help ripen the 2-7 eggs. Spontaneous ovulation is blocked with injections so that eggs could be collected. This approach is also called Soft IVF. It is safer, less expensive and avoids side-effects associated with suppression of hormones in a conventional IVF cycle. It also reduces the risk of Ovarian Hyperstimulation Syndrome (OHSS).