Natural v Medicated FET

[WillowPark]

Hello, I know this has been posted about a few times before but I'm due to have a treatment review shortly. I know as part of this review our team are considering whether we should do our next FET in a natural cycle, and I'm interested to hear views and experiences to help me decide what to do.We have unexplained infertility. We have been lucky enough to make top quality day 5 blasts and my lining has always reached 12ish mm within the first 12 days of a medicated cycle. We had one early bleed in our first round but otherwise everything has been textbook. Textbook perfect IVF, except 5 times we haven't made it past test date and have had BFNs throughout.

I had said earlier in this process that I would prefer medicated cycles - I'd prefer the control and the safety of knowing that I wasn't missing out on an easy fix. However, after 5 rounds and no guarantee how many more we might have to do, I'm aware that I'm keen to continue but hating the drugs. And the idea of doing the next round without the numerous side effects is quite appealing, so I'm considering it...

Any and all wisdom welcomed. Thanks!

[Endofitall]

I’m so sorry you’re suffering recurrent implantation failure as well. There’s good evidence that natural cycles are better if you can do them ie you have ovulatory cycles. I think a lot of UK clinics push medicated simply as they want to schedule you and don’t necessarily have 7 day working.

There’s evidence they have reduced rates of obstetric and neonatal complication (eg pre-eclampsia, pre term birth) vs medicated cycles. I think if you’ve mainly done medicated, natural cycle would be worth a try.

Best of luck 🤞🏼

[WillowPark in reply to Endofitall]

Thank you so much for your reply. This mirrors what the clinic said to me too - they said we should consider it as I have shown I have really regular ovulatory cycles and can support my own womb lining. So they would be happy to go ahead with a natural cycle, and we could benefit from the decreased risks in the event it is successful. I have had 5 fully medicated cycles and really feeling like I don't want to take so many drugs long term! They don't support 7 day working though so I wonder if there is a risk of being cancelled due to scheduling which I will discuss with them.

[Endofitall in reply to WillowPark]

You’re welcome. My clinic was closed on Sunday so I just had to hope so hard that LH surge didn’t land on a Monday 😖that was the only nerve wracking thing. New clinic has 7 day working so that’s better!

[WillowPark in reply to Endofitall]

Wow, that's amazing! Our clinic is open 6 days but I thought they only did frozen transfers on certain days, so that will definitely be one of my questions!

[Vix12345]

I have so far had one fresh cycle which failed, two medicated frozen transfers which were chemical and a non medicated rounds with progesterone support which was successful but I miscarried at 9 weeks.

Our next round we are going to follow the same protocol of the non medicated with progesterone round as this is the closest we have ever gotten and my clinic believe that some people do better without all the extras but I was reluctant to try it previously due to the possibility of the timing not working out or having the cycle cancelled but it was so much easier and less stressful for me, as well as less expensive.

Good luck whatever you chose

[Endofitall in reply to Vix12345]

Good luck with your next round. I’m so sorry about your miscarriage.

I have luteal support with progesterone too. I know others who have had modified natural so no oestrogen medication but have trigger injection when follicle good size rather than relying on own LH surge - that can help a little with timing.

[Doodlebug23 in reply to Endofitall]

This is my current protocol. Trigger then start progesterone (as long as I ovulate). 🙏🏼

[WillowPark in reply to Vix12345]

Thanks, that is so helpful in terms of it being easier and less stressful. That's what I was hoping to hear. Maybe the extra progesterone support might be an option for us too as I am concerned after the first cycle early bleed.

So sorry about your miscarriage, how unfair after finally getting that BFP. It is a really positive sign though that you got that far so remind yourself of that - I'll keep everything crossed that you have cracked the right protocol for you and next round will be successful 🤞

[Vix12345 in reply to WillowPark]

Thank you so much.

It really was so much easier. I barely felt like we were doing an IVF round as wasn't being injected every day and I felt so much better in myself.

I hope it all goes well for you xx

[Doodlebug23]

I’m doing modified natural this time and the relying on my body and the timing scares me tbh. My clinic said they had no preference over natural and motivated so I also have been doing medicated but after 5 failed and 1 chemical they want to give natural a go this time. It does make sense that if you are going with Mother Nature, and she is a formidable beast!

When will your cycle be?

[WillowPark in reply to Doodlebug23]

A formidable beast indeed! I'm not sure as they wouldn't book me in until my next appointment and I'm waiting on that being issued. I'm hoping April! My period started on Saturday night so hoping they will fit me in with my next cycle 🤞 You must be getting started again soon?

[Doodlebug23 in reply to WillowPark]

My period started yesterday so I’m due to start ovulation tests on day 8 all being well. Typically means transfer will fall exactly when it’s most inconvenient with year end at work and school holidays but hey, nothing worth it is easy right?! 🙈

[WillowPark in reply to Doodlebug23]

Absolutely and you know exactly what to expect and how to put up any boundaries you require. You will be fine. Good luck. I've bought some ovulation tests and thought I might track it this month. It has been so long since I tried ovulation test strips and I never had much success with them. I used to track my cycles using BBT. I'd quite like to see the tests working before I agree to go down this route!

[Doodlebug23 in reply to WillowPark]

I’ve not used then since TTC naturally a while ago. After all the BFNs I feel I need to give it another go though seeing as though I’m regular. Clinic didn’t want a test to see if I’m still ovulating which surprised me though. I did get my doctors to do one anyway but not got results yet. I figure if I try it and don’t get the surge then I know. Just means wasting a month but the Frosties will still be there waiting!

[Eternalwarrior]

I found (modified) natural FET so much easier on my body. I have PCOS and do not ovulate regularly. However, after lots of heartache, my clinic agreed to let me try a non-medicated cycle and that is the one that gave me my son! I have one last embryo in the freezer and we are going to follow the same protocol. I know the chances it will work are very low due to my age and it is a C grade embryo, but we will try another natural FET. Good luck! xx

[WillowPark in reply to Eternalwarrior]

That's really good to hear. Part of me wondered if going natural with my current last embryo might be a risk but sounds like you think the opposite and have had more success with the natural route. Thanks so much for replying x

[Eternalwarrior in reply to WillowPark]

It worked for me and I hope it works for you too! Good luck xx

[Natasha2012]

I’m trying natural with progesterone support for the first time next month if my biopsy comes back. Normal . I can’t handle the estrogen side effects . If your lining builds naturally to a decent thickness and you ovulate then it’s a no brainer to me but I appreciate not all clinics do 7 days a week transfers . Good luck ❤️

[WillowPark in reply to Natasha2012]

Thanks, that's really helpful. It isn't the estrogen which gives me the worst side effects, but the progesterone! And the progesterone is the one I worry I need... I'm definitely erring towards natural but will make the final decision in my consultation I think. Thanks for replying 🙂 and good luck!

[Endofitall in reply to WillowPark]

Just to say in natural cycles you can usually get away with lower doses of progesterone because the follicle that ovulated will be making some too.

[WillowPark in reply to Endofitall]

Thanks. I had a lower dose in my first round (with stims). I had 2 x cyclogest and I bled heavily starting 6 days after transfer. Since then I've been on lubion, cyclogest (with no follicle/natural progesterone) and I've not had any bleeding, just the odd day of spotting. So I feel a little like I need it but I don't really know - maybe it is just a comfort blanket!

[Endofitall in reply to WillowPark]

I understand. I also had bleeding after transfer in my first fresh cycle which led to Lubion and higher dose Cyclogest in future cycles. However with the natural FET I was able to use less additional progesterone - they just tested my progesterone the day before transfer to make sure it was good and knew then dose ok to continue post transfer.

[WillowPark in reply to Endofitall]

OK, great. I'll ask them if they can do that and see what they say! Less hopefully means less side effects at least 🙈

[Natasha2012]

to be honest it’s prob the progesterone aswell 😂 xxx