MODIFIED NATURAL CYCLE IVF

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Pure natural cycle IVF and ovulation trigger IVF both have the disadvantage that ovulation may occur before we have the chance to retrieve the eggs.

The use of Modified natural Cycle IVF was introduced several years ago as a way of being the best of all world's

1. Patients are monitored for the first 8 to 10 days and only 1 follicle is allowed to develop therefore we meet our goal of only using the 1 or 2 eggs naturally selected by the body and further avoid the use of costly and unpleasant injections/medications.
2. When the follicle reaches maturity we advise the patients to take cetrotide which is an antagonist.  This antagonist prevents the release of LH pituitary so that ovulation will not occur. This accomplishes the goal of preventing ovulation.

Monitoring, once the follicle reaches 13 to 15mm - patients receive daily doses of cetrotide (antagonist) to prevent the LH surge.  Along with this, patients receive 150IU of fertility medication to allow for continue growth of the follicle and continue rise of the estrogen despite the use of cetrotide which acts to stop follicle growth because it decreases both FSH and LH.

See Example of Modified Natural Cycle IVF

Modified Natural Cycle-IVF is an excellent first option for patients who have no coverage for IVF, because it drastically cuts down  the cost of medication, which usually represents a hefty part of out-of-pocket expense in IVF.

Modified Natural Cycle-IVF in Patients under 35 with normal FSH
a.  Reduces the cost,
b.  Allows for multiple consecutive attempts
c.  Cumulatively offers a clinical pregnancy rate similar to that of stimulated IVF.      without the risk of multiple gestation.

Modified Natural Cycle-IVF in Patients over 35 with normal FSH
a.  The benefit of MODIFIED NATURAL CYCLE-IVF may be less
b.  Low-dose or minimal-dose stimulation may be considered as a first alternative.

Modified Natural Cycle-IVF in Patients over 40 with normal FSH
a.  May have eggs that appear to be normal, but embryo development will be less      optimal than in younger patients.
b.  Also have a higher miscarriage rate and a lower live birth rate.

Modified Natural Cycle-IVF in Patients over 40 with elevated FSH
a.  May consider MODIFIED NATURAL CYCLE-IVF
b.  Should be aware that the pregnancy rate is affected both by age and the      elevated FSH.

Patients who have been poor responders in stimulated cycles, with elevated FSH
a.  May consider Natural Cycle-IVF
b.  Must be aware of poorer prognosis compared younger patients with normal or      even slightly elevated baseline FSH levels.

Modified Natural Cycle IVF live birth rate
Many programs have a >20% live birth rate per embryo transfer with MODIFIED NATURAL CYCLE-IVF in women under age 39.

My personal, individualized approach to fertility care is particularly helpful for MODIFIED NATURAL CYCLE-IVF or MS-IVF cycles, because I do not rush patients into these treatments without first studying their history - especially of past stimulated cycles with or without IVF - and the present pattern of their natural cycles.

When they do undertake MODIFIED NATURAL CYCLE-IVF, then I am much better prepared to anticipate their special requirements in terms of monitoring their cycle.

In this sense, we treat every patient as a special, individual case, and never take anything for granted.

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