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Age and Infertility: Natural Cycle IVF

a blog by Dr. Michael DiMattina, Dominion Fertility, January 21, 2015

Many patients with advanced reproductive age often pursue egg donor IVF or adoption particularly when they have failed stimulated IVF. Some try Natural Cycle IVF (NCIVF) first. And here’s why!

In early 2013, a local Gyn Oncologist and colleague referred to me her 44 year old patient for egg cryopreservation. At her age egg freezing was not a good option, so I recommended that she try to conceive immediately rather than cryopreserve her eggs (egg cryopreservation is best for women 38 or younger and generally not recommended for women over 40 years old).

In late 2014, she decided to undergo treatment using Natural Cycle IVF. Her menstrual cycles were regular occurring every 25-29 days. She had never tried any other fertility treatments but she was interested in first trying NCIVF. In November, we aspirated and fertilized her egg and three days later transferred a single, 8-cell embryo. In December, we confirmed a viable 7 1/2 week fetus and referred her for obstetrical care.

About three years ago, I treated a 47-year-old patient using NCIVF and her own egg and she also got pregnant with her first embryo transfer, delivering a healthy baby at age 48. Both of these individuals are extremely fortunate to have such success given their advanced reproductive ages but we are extremely pleased for their success.

Last year, I reported our success with NCIVF compared with stimulated IVF (“Natural Cycle IVF implantation rates compared to stimulated IVF and role of serum antimullerian hormone levels,” IVF Lite, March, 2014, issue 2). We found that the implantation rates for NCIVF were superior to stimulated IVF in all patients 35-40 years old and the implantation rates were independent of serum AMH. In other words, patients with poor ovarian reserve based on low AMH levels, had the same likelihood for pregnancy as patients with normal AMH. This is good news as NCIVF offers hope for those patients with regular menstrual cycles and poor ovarian reserve and NCIVF may be considered as a treatment option prior to using ova donor IVF or adoption.

We hope to have more successful patients and fun stories for you in 2015!

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