Do They Work As Well As Conventional IVF?
You may see ads and articles for “minimal stimulation IVF” and “natural cycle IVF” or “natural IVF.” These sound very appealing—who doesn’t like “natural”?
And these treatments use no fertility drugs or a minimal amount of the drugs, which are a significant part of the cost of fertility treatment. But do these techniques work? Let’s look at the latest facts.
A Quick Recap Of How IVF Works
In vitro fertilization was developed to help people have a baby who hadn’t been successful the old-fashioned way due to fertility issues of many kinds, both in the male and the female, and is now often used by same-sex couples as well to conceive with donor eggs, sperm or surrogates. Basically, the woman’s ovaries are stimulated by the use of fertility drugs to produce multiple ripe eggs, which are then retrieved.
The eggs are fertilized with the man’s sperm in the laboratory. Fertilized eggs then grow into embryos, which are either transferred to the woman’s uterus or frozen for transfer if needed later. Fertility drugs are used to increase the chances of getting multiple eggs and embryos, which then increase your chance of getting pregnant by implanting more than one embryo or performing more than one IVF cycle if needed.
Most patients will be prescribed both clomiphene citrate (Clomid or other brand names) and injectable hormones called gonadotropins to stimulate their ovaries to produce eggs. Side effects are usually mild, but anyone using the injectable drugs will be closely monitored to make sure she is not having severe reactions.
In a normal menstrual cycle, typically one egg will ripen and be released by your ovary. Natural cycle IVF is a form of in vitro fertilization which does not use any fertility drugs to stimulate the production of multiple eggs, as is typically done with conventional IVF. Egg retrieval is performed to try to remove the single egg, and if retrieval is successful, then the lab attempts to fertilize the egg in the same way as conventional IVF. Then, if a viable embryo results, the embryo is transferred to the uterus, again in the same way as conventional IVF. Some fertility clinics offer natural cycle IVF for people who can’t afford conventional IVF or who don’t want to use fertility drugs. Natural IVF decreases the cost of the protocol but also decreases the success rate, according to the American Society for Reproductive Medicine (ASRM.)
Experts say the chance of having a baby with natural IVF is 7 to 10 percent per cycle. The success rate of conventional IVF varies, but ranges from 20 to 40 percent per cycle, depending on the age of the woman and other factors.
Minimal Stimulation IVF and Mini-IVF
Minimal stimulation IVF is similar to natural IVF but uses low doses of fertility medications to try and produce two to four eggs. Theoretically, the advantages of this approach include lower cost, fewer injections and reduced monitoring. This type of IVF may also be appealing to couples who do not want to freeze embryos for religious or ethical reasons. However, ASRM observes that minimal stimulation IVF also has lower success rates than conventional IVF.
A similar protocol known as “mini-IVF” has recently been developed and is being tested. In mini-IVF the patient takes low doses of clomiphene citrate for 10 to 12 days, which is longer than it is normally prescribed in more conventional IVF, and does not use injectable fertility drugs. The eggs which are produced are then retrieved. The lab fertilizes the eggs with the male’s sperm and transfers or freezes embryos in the same way as conventional IVF. However, more testing is needed before this procedure will become widely accepted and available.
Tried and True vs. Something New
If you’re considering one of these newer protocols be sure to weigh the pros and cons. More conventional IVF has a track record decades long and success rates are readily available for any fertility clinic. If one of the newer procedures is appealing to you, make sure you choose your fertility specialist carefully and ask a lot of questions about their success with women your age.