IVF in the natural cycle: reviews, preparation, chances. How is IVF

2024 Author: Priscilla Miln | [email protected]. Last modified: 2023-12-16 00:21

One of the gentle methods of artificial insemination is IVF in the natural cycle. Patient reviews confirm that no risks and complications can be expected, but the effectiveness of the procedure is quite low. In addition, IVF at the EC is not suitable for all patients, but it is a way to reduce the hormonal load on the body if there are contraindications to standard protocols.

Classic IVF procedure

How is IVF (in vitro fertilization) done? The standard procedure involves the fertilization of eggs (own or donor) in the laboratory and their subsequent replanting into the uterine cavity. Multiple growth of oocytes is achieved by stimulation, which can take place in short or long patterns.

Short IVF protocol lasts about four weeks. Fertilization according to the long scheme involves the creation of a completely artificial hormonal background. So, for a while, the patient is actually introducedinto an artificial menopause, which stops the progression of hormone-dependent gynecological diseases.

As part of preparing a woman for IVF, hormonal preparations are prescribed, under the influence of which the eggs actively mature. Depending on how sensitive the body is to therapy, from one to twenty viable eggs can mature in one cycle.

Not all sex cells reach maturity sufficient for successful fertilization and further development, so some are discarded. "Get out" from the ovaries of a woman oocytes by puncture. This is a minimally invasive surgical procedure, during which a special needle with an ultrasound sensor is used to collect follicular fluid. Together with the liquid, the eggs enter the test tube.

Classic IVF involves self-fertilization in an environment that is as close to natural conditions as possible. With a favorable set of circumstances, the resulting few high-quality (most viable) embryos are planted back into the female body. The procedure is called embryo transfer. When pregnancy occurs, then everything happens naturally.

Why stimulate?

Reviews of IVF in the natural cycle often indicate that this is a less traumatic method of artificial insemination for women's he alth, because strong hormone therapy can be excluded. Indeed, the preparation of a woman by prescribing a course of hormonal drugs is a mandatory step in the protocol.artificial insemination.

Why is there any medical preparation of a woman for participation in the protocol? The list of indications for IVF includes gynecological diseases and other pathological conditions of the body that prevent the onset of ovulation, which means that pregnancy is also impossible. But stimulation is carried out even if the eggs are developing.

It is necessary that the fertility doctor has a choice of eggs, and in the future - embryos. The “quality” (viability) of the biological material determines whether pregnancy occurs after the procedure. A fertilized egg may not take root or be damaged, so that development stops. So hormonal stimulation in preparing a woman for IVF is necessary to increase the effectiveness of the procedure.

IVF in natural cycle

IVF is carried out in a natural cycle without stimulation or with stimulation in a significantly reduced volume. In the absence of medical intervention in the functioning of the female body, the growth of one of the follicles in each menstrual cycle is provided by the hormones LH and FSH, which are produced in the pituitary gland and released into the blood. The most complete follicle reacts to this “hormonal release”. In the future, the egg grows and matures in it.

When the oocyte reaches the required size, the brain sends a large dose of LH to the ovaries. As a result, the egg finally matures, detaches from the wall of the follicle,rupture of the membrane occurs - ovulation. Prior to this, the reproductive specialist must receive an egg and stop ovulation. In this case, it is very important to correctly determine the moment, because an immature egg will be unsuitable for fertilization. Modern medicine uses special media that allow the immature oocyte to mature properly and become suitable for fertilization.

Main indications for IVF in EC

The procedure is performed only for those women who have preserved the natural ability to ovulate. The greatest efficiency of the method is observed for women aged 18-35 years. Mandatory conditions are the regularity of the menstrual cycle, ovulation, confirmed by ultrasound and hormonal research. At the same time, the absence of ovulation in several cycles during the year and the maturation of two eggs (instead of one) is considered the norm.

IVF in the natural cycle can be indicated for women who cannot become pregnant due to male factors, have previously suffered from thromboembolism or cancer, are at risk for ovarian hyperstimulation syndrome, want to avoid excessive hormonal stress, have a weak body response on hormonal stimulation, suffer from diseases of the pancreas and liver.

Possible difficulties and disadvantages

What does IVF in the natural cycle mean? This is the same artificial insemination procedure, only without the need for strong hormone therapy that stimulates the growth of a large number of eggs.

Despite the fact thatthe method is considered more natural and safer for he alth, reproductive specialists cannot control the maturation of the egg, the peak of LH hormone production, the final ripening and the very moment of ovulation. As a result, a number of difficulties may arise.

In the reviews of IVF in the natural cycle, you can find various examples of difficult situations that lead to the ineffectiveness of the procedure. During the puncture, doctors can only receive follicular fluid without an egg if the oocyte is not fully mature and has not had time to move away from the wall.

The egg obtained as a result of puncture may simply be unsuitable for the procedure due to insufficient maturity or degeneration. The natural process is not controlled at all stages, so this is quite possible. In addition, at the time of the puncture, the follicle may be empty. This means that ovulation has already occurred.

Under an ideal set of circumstances, doctors receive only one oocyte, which is fertilized. With additional stimulation with hormones, it is possible in the laboratory or even in the body of a woman to artificially provoke the maturation of the follicle or suspend ovulation until the oocyte puncture.

Steps of the procedure

How is IVF going? At the preparation stage, ultrasound monitoring of the development of the follicle is carried out. The procedure is repeated in dynamics from the seventh to the eighth day of the menstrual cycle. Later, the peak of LH production is determined using special test strips, ultrasound and hormonal studies.

Based on receiveddata, the reproductologist plans a puncture, and about two days before that, he recommends an injection of hCG so that the pregnancy is not rejected by the body immediately after the embryo is replanted. After the puncture, the partner's sperm is taken or a donor is used. The doctor cultivates the resulting embryo, and on the second or third day of development, implants it into the uterine cavity. In this case, medical support for pregnancy is not required.

Individual IVF program at EC

To prevent the ineffectiveness of the procedure, reproductologists develop an individual protocol scheme for each patient. Preparing a woman for IVF begins with taking drugs that prevent premature aging of the egg. They begin to be injected when the follicle reaches a size of 14 mm.

HCG preparations are used for the final ripening. The time of egg puncture is calculated from the administration of the drug. At the same time, attempts to medicate the reproductive system do not always lead to a positive result. Full control is possible only when using standard artificial insemination schemes.

Preparing a man for sperm collection

An individual scheme for a man is usually not developed. Recommendations are given mainly to women. However, a certain preparation of a man for IVF is also necessary (even if the spouse is he althy). To increase the chances of success, you need to stop drinking alcohol, drugs, smoking, water procedures, which are associated with thermal effects on the genitals. You need to have a regular sex life anddo not wear tight underwear.

Preparing a man for IVF involves taking some vitamins that will improve the quality of seminal fluid. To ensure normal spermatogenesis, drugs of group B are prescribed. Folic acid is taken in the form of tablets, which takes part in the synthesis of DNA and RNA.

Importance of IVF in natural cycles

Judging by the reviews, IVF in natural cycles is still of great importance, despite the possible difficulties. There is a certain group of women for whom this method is considered the most preferable. So, with a combination of young age and a high risk of complications or infertility, consisting in tubal or male factors, the procedure can be effective and help to avoid hormonal stress on the body.

When the ovarian reserve is depleted, the natural cycle procedure allows the body to independently choose the he althiest and strongest follicle, which contains a genetically complete oocyte. In addition, there is no risk of hyperstimulation. IVF at the EC is successfully carried out even if there are contraindications to the standard protocol (oncology, benign neoplasms in the mammary glands), which involves a serious medication load.

Artificial insemination in the EC after 40 years

After the age of 40, the ovarian reserve is only 3%, which is accompanied by a decrease in the likelihood of a natural pregnancy. Official statistics confirm that the number of pregnancies that started naturally inaged 41 to 45 years, is only 5%. The risk of failure is increasing because the eggs left in the ovaries age faster than the body as a whole.

For a reproductologist, IVF in the natural cycle at an older reproductive age becomes a difficult task. This scheme involves the rejection of hormonal drugs or their minimal use. The disadvantage of the method is that as a result of the puncture, only one or two eggs are obtained, which at this age women may well be unviable.

Increase the chances of patients over 40

The chances of success of the procedure increase with early contact with the clinic and careful diagnosis. If the ovarian reserve is normal, then it is possible to use the IVF protocol in the natural cycle. It is important that there are no concomitant diseases and a high-quality spermogram of the partner.

If necessary, you can turn to additional technologies, namely pre-implantation diagnosis (the chromosome set of the embryo is examined) and embryo hatching (helps cells to implant). After the transfer of embryos into the uterus, medical support for pregnancy is needed.

Effectiveness of the IVF procedure

Unsuccessful IVF in the natural cycle is not uncommon. The effectiveness of the method is 2-10%. Artificial methods do not always allow you to get pregnant the first time, but the percentage of any complications is low. For this reason, IVF at the EC is a choice that is made based on the state of he alth andcharacteristics of the patients. So, with IVF in the natural cycle after 40 years, there is little hope of success, but if this is the only opportunity to become parents, then it is definitely worth a try.

Cost of participation in the IVF protocol

IVF protocols in the natural cycle are offered by many clinics. The interest of specialists in this method is increasing, because the procedure allows you to reduce risks and make fertilization cycles as safe as possible. How much does IVF cost in 2018? The cost of artificial insemination with stimulation is 100-150 thousand rubles.

How much does IVF cost in 2018 in Moscow? If there is no need to carry out hormonal stimulation, then the procedure will cost 70-100 thousand rubles. When using donor cells, you will have to pay up to 200 thousand rubles for the opportunity to become parents, excluding the cost of donor material. Total expenses can reach 400 thousand rubles.