Natural IVF/Mini IVF
What is Natural IVF or Mini IVF?
The concept and purpose of the natural IVF treatment is to allow nature to select the best follicle/egg known as the “dominant follicle”. The dominant follicle is followed without any intervention until mature. Once mature, the follicle is aspirated transvaginally and the resulting egg is then inseminated with the use of the partner or donor sperm and the resulting embryo is transferred back to the uterus. During a natural IVF cycle there is no or minimal use of fertility drugs.
How does natural IVF work?
At the initiation of every menstrual cycle a cohort of follicles (eggs) begins to grow. The number of follicles that are growing depends on multiple factors such as the women’s age, her individual fertility and others. For women in their 20s the number of follicles that begin to grow each month is approximately 15-20. This number is reduced to approximately 2-4 follicles per month after the age of 40. With traditional IVF the hormonal treatment is initiated at the beginning of the menstrual cycle with the purpose of allowing for multiple follicles to grow. The medications are usually started on the third day of the menstrual cycle and continued for 9-10 days until the follicles/eggs reach maturity. The follicles once mature are aspirated transvaginally. While the concept of “traditional IVF” is to grow and obtain multiple eggs per cycle the concept behind the natural IVF is very different. The purpose of a natural IVF cycle is to follow single follicles selected by nature as the strongest / healthier. The selected follicle is followed with sonograms without intervention until it reaches maturity. Once mature the dominant follicle is aspirated. The idea behind natural IVF is to allow nature to select the best follicle and then use that follicle only for insemination and embryo transfer.
What are the main indications for the use of natural IVF?
Women regardless of age with very low/no response to traditional IVF.
Women regardless of age who are considered very poor candidates for traditional IVF due to the number of follicles and/ or ovarian reserve tests (High FSH, Low AMH).
Women who have a contraindication for hormonal treatment.
Women who desire to have a more “natural” approach and are trying to avoid the use of fertility medications.
Advantages and disadvantages to the use of natural or mini IVF:
One of the main advantages of the natural IVF cycle is that it can be performed on any women even with severe “diminished ovarian reserve” such as women with very high FSH, very low AMH, as long as they still ovulate.
Natural IVF/minimal IVF is relatively cheaper compared to a regular IVF since less medications/appointments are needed.
Very low risk of multiple pregnancies and other complications that are encountered in regular IVF such as ovarian hyperstimulation syndrome
The main disadvantage of the natural IVF cycle compared to the traditional IVF is a relatively low success rate compared to the traditional IVF and high risk of cycle cancellation. During a natural IVF cycle there is an increased risk of cancellation of the cycle due to premature ovulation, finding no egg during egg retrieval, no fertilization, no embryo formation or very low quality embryo that is not suitable for embryo transfer. Success rate of natural IVF per one attempt can be lower than 10%.
As with any fertility treatment, natural IVF is a good option but its use needs to be tailored to the patient and the underlying diagnosis. If you have any additional questions regarding natural IVF please contact Paula at firstname.lastname@example.org