Natural vs medicated

[SianieShorts]

Just after some advice really and wondered what your thoughts are…

I am embarking on FET (will be my 6th transfer) and enquired about going for natural/modified natural at my last consultation. This was kind of pushed to the side as an idea and I was told my clinic don’t really offer this.

Fast forward a month and I had a phone call to say that due to the difficulty in getting buseralin at the moment, the clinic are changing all cycles to natural/modified natural.

I’m not adverse to this but am concerned as I have a short luteal phase (ovulating at day 21/22 of a 28 day cycle). The clinic didn’t seem to think this was of significance.

Can anyone offer any help or reassurance?

Many thanks for reading

[HedgehogMad]

Hi lovely! Natural/modified natural FETs have just as good (maybe even slightly better) success rates than medicated so I wouldn't worry. If you have a short luteal phase it might mean your progesterone levels are a little low, but nowadays most clinics supplement with extra progesterone during the luteal phase anyway. So I would ask your clinic to give you progesterone pessaries and maybe also injections to support your luteal phase. I've done a few natural FETs and it is so much gentler on the body as it just works with your natural cycle xx

[SianieShorts in reply to HedgehogMad]

Thank you for your reply. That’s great reassurance! I am definitely looking forward to less injections!! Good luck to you x

[Maui2020]

Hi there! Just want to reassure you- I’ve been extremely Iucky to have 2 ivf babies now, both have been natural FET cycles. I’ve done 7 of them in total. I didn’t respond well to medicated cycles, I couldn’t get my lining as good. My cycles are pretty regular but actually both of the successful ones I had a late ovulation. There is also a method my clinic used where they track lining and follicle, and then trigger ovulation when you’re naturally ready so the predicted ovulation time can be used to time transfer more accurately. I was also given extra progesterone. A lot of clinics avoid natural FET as it requires more appointment time due to monitoring and your transfer date cannot be manipulated. But for women with regular ovulation it’s nice to be drug free and has the same success rate. When I was choosing clinics my first question would be whether they offered this. Good luck xxx

[SianieShorts in reply to Maui2020]

Thank you so much for your reply and great to know you had success with natural FET. My first round of IVF was successful back in 2017 and this was medicated but all subsequent transfers have failed. Fingers crossed we get a sibling this time 🤞🏽🙏🏻❤️

[SianieShorts in reply to Maui2020]

Do they still track ovulation in a frozen cycle? I thought they wouldn’t want you to ovulate unless having a collection?? X

[Maui2020 in reply to SianieShorts]

They track ovulation to time the transfer. If they can trigger the ovulation that’s even better as they know the 12 hour window it’s occurring in. And it’s fine for you to ovulate, the body is tricked into thinking that the egg you have ovulated has gone onto become the embryo that is transferred. Hope that makes sense. Fingers crossed for you xxx

[SianieShorts in reply to Maui2020]

ah yes…I understand now. Thank you for explaining x

[DianeArnold Partner Nurse Fertility Network UK]

Hi SianieShorts. Perhaps try the modified version for more control. Either or, but I do hear of more successes with mild medication. Good luck! Diane

[SianieShorts in reply to DianeArnold]

thanks Diane. Yes, I definitely think I need the progesterone to support the luteal phase x

[Tnthketnf]

A couple of recent studies found no real difference in the pregnancy rates in the different types of frozen transfers. That should be reassuring. I will try and link them here. I would ask for natural modified with luteal support this way the ovulation and transfer time are calculated more accurately and the progesterone support should offer some reassurance for the short luteal phase. My last clinic was NHS and they did not offer the modified type. Only true natural but they didn't have an issue about the extra progesterone. Happy to prescribe it even though there's no evidence that it helps, just fo my reassurance.

[SianieShorts in reply to Tnthketnf]

thank you for replying and your advice. I agree, I will feel much more reassured with extra progesterone!

Does the ovulation matter so much in a frozen cycle? I thought they wouldn’t want you to ovulate unless doing a collection? X

[Tnthketnf in reply to SianieShorts]

I hope all goes well!In a medicated cycle they dont want you to ovulate. In a natural they want you to.

[Tnthketnf]

remembryo.com/comparing-fro...

ncbi.nlm.nih.gov/pmc/articl...

[SianieShorts in reply to Tnthketnf]

thank you so much for these links x

[Twiglet2]

i did a lot of research into this if you have regular periods and cycle length then there doesn’t seem to be any difference in success rates. I have tried both and the natural one was not only much faster but much kinder on the body than the down reg cycle they will monitor you for your ovulation day anyways whenever that might come. Definitely ask them though to show you evidence that you are not being disadvantaged by this method in your particular circumstances. My clinic originally dismissed natural to me too but it wasn’t due to success rates more to do with the unpredictable nature of going with our cycles meant it was harder for them to plan and fit more ladies in each month (they only take 2 natural per week due to this so took me a few months to get booked in) so I suspect they may have dismissed you originally for a similar reason around how they work perhaps so probably one to ask them about too, lots of luck 💜xx

[SianieShorts in reply to Twiglet2]

many thanks. I think you are right…it was more to do with the fact they don’t do transfers on the weekend so they said if your transfer fell then, it would be cancelled untill the next cycle.

Good luck to you x

[SianieShorts in reply to Twiglet2]

How are you? I see you have had a bad time of it recently xx

[Twiglet2 in reply to SianieShorts]

thanks for asking 🤗 we are just healing counting our blessings and thinking of next steps 💜 nothing else for it lol xx

[Positivechangeplease]

Hi!

So I did two FETs. One medicated and one naturally modified. The first didn’t work but the second did.

I had no idea what luteal phase I had or when exactly I was ovulating. My period was always between 25 to 31 days and mostly at 28-29 days, but apparently the main thing is you need the womb to grow by day 8-10 and you track ovulation from the usual point on the clear blue ovulation but you check ovulation morning and night. I was to phone the consultant whenever I got the smiley stuck face. It so happened I had a scan the next day so he said to keep that as is and go in. They checked me and said I was ready and to get the trigger pen HCG and do it that night, then I started on progesterone pessaries two days later and then 6 days later we transferred the day 5 embryo.

Hey presto I now I have a 7 month old ❤️

[SianieShorts in reply to Positivechangeplease]

thank you so much for replying. I feel very reassured by your experience. Many congratulations 🥳 x

[Positivechangeplease in reply to SianieShorts]

I’m glad I could help! Good luck!

[MariaHdz]

I had 3 artificial FET, and it did not work. My new reproductive endocrinologist told me that they wanted to try natural cycles as the artificial ones were not working and it finally worked for me. So it is a good chance to try, they are more intensive regarding check ups (they check progesterone and everything). So any thing bad with your progesterone or lutheal pahse they will detect it

[SianieShorts in reply to MariaHdz]

many thanks for replying. It is very reassuring to hear natural ivf has worked for you. Congratulations 🥳 xx

[Fruitandflowers]

Similar to others, I had two chemicals/early losses on fresh transfers and I've always had spotting before periods which I suspect was due to progesterone. My first FET was at a private clinic and they were able to go off my natural cycle but added oestrogen and progesterone, both of which needed to be adjusted as we went along but I found the process sooo much gentler and somehow more natural, and I understood what the meds were and how I would react so felt I could advocate more for myself. I got a BFP at 3dpt(!) and that's now my little girl. I've never got on with down regging but maybe because I have a regular cycle it was easier to fit me in and the natural modified (which I think is what it's called) was ok for me. Even so my NHS clinic said they can't deal with the unpredictability of natural or natural modified, and even normal FETs had a huge wait, which is one of the reasons I ended up going private.

[SianieShorts in reply to Fruitandflowers]

thank you for your reply. I am so happy to hear you had success with natural ivf. Congratulations on your baby girl 🥳 x