Mild IVF
Who are the best candidates for mild or natural cycle IVF treatment?
Mild or natural cycle in-vitro fertilization (IVF) could be indicated for the same reasons as standard IVF treatment (female and/or male factors), but usually is proposed either in good-prognosis, younger patients (37 years or younger) or in those older patients who have a very low ovarian reserve and are not likely to produce many eggs even with a high-dose stimulation. Mild stimulation approaches are associated with less side effects and a less invasive egg collection procedure
What tests are needed before starting mild or natural cycle IVF?
Before starting mild IVF treatment an initial consultation is done with the evaluation of the female patient’s ovarian reserve through ultrasound scanning and hormone tests and for the male a detailed sperm analysis. A simple bloodwork such as blood count, clotting screen, and infectious screening is also requested for both partners before starting treatment.
What is the process of mild or natural cycle in-vitro fertilization?
Mild IVF treatment involves the process of a 10-12 day long ovarian stimulation with low-dose subcutaneous injections and serial ultrasound monitoring culminating in the egg collection which is a short 10-minute procedure performed under sedation or in some cases even in using local anaesthesia. With natural cycle IVF no stimulation is used, but close monitoring is still required. Retrieved egg(s) are checked by the embryologist in the lab and those that are mature will available fertilised conventionally or using the ICSI procedure. Resulting embryos cultured for 3 or 5 days and one of them will be transferred back to the womb. A pregnancy test 10-14 days after embryo transfer will confirm whether the embryo has implanted or not.
What methods are used to fertilize eggs during mild or natural cycle IVF?
Egg(s) harvested following egg collection could be fertilised using conventional IVF (when a significant amount of sperm is incubated together with each egg in a dish) or with the intracytoplasmic sperm injection or ICSI procedure (when a single selected sperm cell is injected under the microscope by the embryologist into each mature egg). However, with a lower number of eggs retrieved ICSI is often the preferred method with the aim of optimising fertilization.
What are the side-effects and risks of mild or natural cycle IVF?
Mild or natural cycle IVF is associated with less side effects and a less invasive egg collection procedure. Bloating, lower abdominal discomfort, breast tenderness is diminished or inexistent due to a much lower ovarian response or due to the presence of a single dominant follicle only. In suitable patients, the egg collection procedure could be performed even without any or local anaesthesia only.
Is mild or natural cycle IVF a safe procedure?
Mild or natural cycle IVF is a safe procedure. Due to a milder ovarian response the risk of ovarian hyperstimulation syndrome is practically eliminated and the surgical risk the egg collection procedure itself is also greatly reduced. There are no reported long-term side effects and if needed mild or natural cycle IVF cycles could be repeated even more often than conventional IVF stimulation.
What is the success rate of mild or natural cycle IVF?
The success rate of mild or natural cycle IVF largely depends on the female age, but also on the quality of sperm and factors related to the womb and embryo implantation. However, compared to conventional IVF because of a lower number of eggs retrieved (or only one egg with natural cycle IVF) the risk of not having an embryo to transfer is higher. Usually, in younger patients (<35 years) pregnancy rates per embryo transfer could be satisfactory (40-45%). Compared to conventional IVF the cumulative pregnancy rate from one stimulation attempt could be lower, but mild or natural cycle IVF could be repeated more easily.