Natural and Minimal Stimulation IVF: The Gentle Approach

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A cheaper, gentler form of IVF for those on a budget to consider is either Natural cycle IVF or minimal stimulation IVF where either no fertility stimulating drugs or very low doses of drugs are used.

Why Would I Want To Have Natural or Minimal Stimulation IVF?

Natural and Minimal Stimulation IVF is a fraction of the cost of standard IVF, so it may be a more affordable option for you.

You may be advised by your fertility specialist to take this approach because of medical reasons (for instance, a past history of breast cancer or severe hormone related depression), or you may have reacted badly to a course of fertility drugs before.

This approach may also suitable for:

  • Women who have experienced severe ovarian hyper stimulation syndrome (OHSS) may be offered this type of treatment to reduce the risk of the condition occurring again.
  • In some cases where traditional IVF cycles repeatedly fail to produce a pregnancy using a more “natural” cycle may provide an answer.
  • For women in their 20s and 30s who are at risk of premature menopause (with irregular ovulation and high levels of serum FSH), “Natural IVF may also be a viable solution, particularly if other infertility factors are present.
  • Some couples just don’t like lots of drugs and prefer keep them to a minimum.

What Is Involved?

During a conventional IVF cycle, the woman takes quite high doses of drugs which work to stimulate the ovaries to produce lots of eggs at once. These drugs can produce adverse side effects such as ovarian hyperstimuation (OHSS).

Natural IVF relies on a womans own ability to produce an egg during her cycle. Usually there is just one, but rarely there may be two. Medication (in the form of an injection or course of injections) is given to stop premature release of the egg. Very careful follicle tracking is crucial by way of ultrasound scans and blood tests, starting several days before the anticipated day of ovulation. As with standard IVF you will be asked to inject yourself with a trigger injection once the ovary has produced one or more follicles that could be expected to hold a mature egg. You will then be scheduled to have an egg retrieval operation done (passing a fine needle through the vaginal wall to retrieve the eggs from the follicles). This procedure is exactly the same as for a standard IVF cycle.

If an egg(s) is able to be collected it is then fertilized in the same way as in a standard IVF cycle, or injected with a single sperm (ICSI). If there is an embryo created and it is of suitable quality to transfer, it will be transferred into your uterus (the same as for standard IVF). You will be given medication after your embryo transfer to keep the lining of the uterus in optimum condition and you will have to wait 2 weeks for a pregnancy blood test to see if the embryo transfer has worked.

Minimal Stimulation IVF uses either tablets or low doses of injected hormones that typically start on the 5th day of your cycle. This aims to ensure that you generate at least one and sometimes 2 or 3 eggs. Medication (in the form of an injection or course of injections) is given to stop premature release of the egg. You will be carefully monitored with ultrasounds and blood tests. You will be asked to give yourself a trigger injection and will be scheduled for an egg retrieval procedure. Any eggs collected are fertilized. If there are embryos of good quality then they will be transferred to your uterus. Additional medicines (either injections or a vaginal gel) are given to help keep the uterine lining in optimal condition and you will wait for 2 weeks for a pregnancy blood test.

What Are The Advantages To Natural And Mininmal Stimulation IVF?

The main advantage is affordability. With “Natural and Minimal Stimulation IVF” there is a reduced out of pocket cost (approx. $1,500 – $2,000 compared to $4000 with standard IVF depending upon medications needed and level of health insurance)

The procedure produces less hormonal side effects, including discomfort from the ovaries as the degree of stimulation is kept to a minimum.

For those with religious or personal concerns about surplus eggs or embryos being either stored or destroyed, Natural or Minimal Stimulation IVF offers a way to reduce the number of eggs collected and embryos created.

Pregnancy rates: if you are successful in having an embryo transferred to your uterus then the chance of pregnancy is very similar to a standard IVF cycle.

Minimizes any risks associated with taking fertility drugs for patients who have medical problems, such as patients living with cancer. Reduces significantly the risk of ovarian hyper-stimulation (OHSS)

What Are The Disadvantages Of Natural Or Minimal Stimulation IVF?

There is an increased chance that your cycle will be cancelled before the egg retrieval procedure due to a low response or unplanned ovulation.

There is a higher chance of no eggs being collected at the egg collection. Up to 25% of cycle may not produce an egg, and this can be as high as 50% when there is only one follicle on the ovary.

There are fewer eggs collected with this method when compared to a standard IVF cycle (1-4 eggs).

There is a higher chance of no eggs fertilising and therefore there not being an embryo transfer. This is because of a lower number of eggs collected means that there will be less embryos available to be transferred and there is a chance that there may be no embryos to transfer.

There is a higher chance of not having any embryos suitable for freezing for future use.

It is not suitable for women who don’t ovulate and it can be a difficult treatment to embark upon if the woman has irregular periods.

If you have been considering an IVF cycle and think that Natural or “Min Stim” IVF might be right for you, please make an appointment to see your fertility specialist to discuss this further or call Fertility Solutions at 1300 337 845 (1300 FERTILITY).