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Should You Do Natural Cycle IVF or Mini-IVF?
September 6, 2013
The majority of fertility centers begin a fertility patient on a conventional IVF protocol where clinically indicated, but natural cycle IVF or minimal stimulation (mini-IVF) may be just as effective at a lower cost and less risk to the patient’s health.
Frank Yelian, M.D. of Life IVF Center, says: “[Conventional IVF] has been successful, otherwise no one would do it, but we believe it is outdated. It only takes one egg to result in a pregnancy, so why do we need ten to twenty? It is inefficient.” Dr. Yelian maintains that current technologies like intracytoplasmic sperm injection (ICSI) and preimplantation genetic diagnosis (PGD) allow doctors to find the embryo with greatest potential for developing into a successful pregnancy. Because of these technologies, the need for aggressive ovarian stimulation and the risk of developing Ovarian Hyperstimulation Syndrome (OHSS) can be virtually eliminated.
Natural cycle IVF requires no ovarian stimulation drugs, therefore less monitoring via ultrasound and blood work. Follicles are monitored in their natural progression and are triggered for ovulation between 18-19 millimeters. Approximately 36 hours later, an egg retrieval is performed. “The goal of natural cycle IVF is to retrieve usually one or two eggs. The quality of these eggs has been proven very good and the pregnancy rates are also good with single embryo transfer (SET). With conventional IVF, between ten and 20 eggs are retrieved each cycle and not all of those eggs are good; usually between one and three eggs are of good quality. For older women, only one or two of those become good embryos,” Yelian explains.
Mini-IVF involves the use of low dose ovarian stimulation drugs and ovulation trigger. Upon egg retrieval, fertility doctors strive to obtain three or four eggs to create good quality embryos for transfer and potentially freezing.
Benefits of natural cycle IVF and mini-IVF include:
- Cost effectiveness
- Fewer health risks
- Better egg and embryo quality for some patients, as they are not subjected to fertility drugs
- No incidence of multiples
- Time efficiency in regards to length of the cycle and time spent in egg retrieval procedure
- Fewer ethical concerns regarding the creation and destruction of embryos
Typically, fertility doctors recommend a lower stimulation protocol like mini-IVF or natural cycle IVF for patients who have failed several conventional IVF cycles, those with high FSH, or patients with low ovarian reserve. However, Dr. Yelian treats young patients between 25-35 years of age, those with tubal blockage, or those dealing with male factor infertility with natural cycle or mini-IVF as well. “Really, all patients are candidates for natural cycle IVF or mini-IVF,” he says. Dr. Yelian strongly believes that natural cycle or minimal stimulation cycle combined with genetic screening and single embryo transfer are the future of IVF.