USC Fertility Launches New Study Examining
Natural cycle IVF (in vitro fertilization) is very similar to standard in vitro fertilization, but just without the use of medications to stimulate the ovary to make multiples eggs (sometimes a small amount of medication is used to prevent ovulation). Patients are monitored in a natural cycle with ultrasounds and blood work to track the growth of the dominant follicle. An egg retrieval is then performed when the dominant follicle is determined to be an appropriate size. The egg that is retrieved is then fertilized in the laboratory in the same way as traditional IVF. If an embryo is produced and continues to develop, it is transferred back to the uterus, again in the same manner as conventional IVF.
Natural cycle IVF has recently made a resurgence, gaining worldwide attention as an alternative to conventional IVF for both normal and poor responders. Natural cycle IVF has several advantages over standard IVF, including the elimination of the risk of ovarian hyperstimulation syndrome (OHSS), very low or no costly and cumbersome gonadotropin injections, lack of production of excess embryos and the elimination of multiple pregnancies.
USC Fertility was one of the first programs to publish its experience with different aspects of natural cycle IVF, and we released our success rates in 1989, 1990, 1992, and 1998. In the 1992 study, we found that although the pregnancy rate was one half of that in stimulated cycles, the per embryo implantation rate was higher in natural cycle than in stimulated cycles. Now that the typical IVF pregnancy rate is much higher than the pregnancy rates in 1992, we anticipate the success rates with natural cycle IVF will also be higher.
The 2010 Study
The goal of this new study is to prospectively study women undergoing natural cycle IVF and their pregnancy outcomes. Our objective is to determine if the advances in technology over the last 20 years have improved pregnancy rates in the setting of natural cycle IVF to further validate its use for patients of all ages and varying prognosis.
Our primary objective is to gather live birth rates, miscarriage rates, and clinical pregnancy rates of women undergoing natural cycle IVF. The secondary objective will be to gather data on number of eggs retrieved, number of immature eggs, fertilization rates and embryo number and quality, embryo implantation rates, and peak estrogen levels.
Our aim is to enroll and monitor patients undergoing natural cycle IVF over the course of the next two years.
1. Women of reproductive age up to a limit of age 46
2. Day 3 FSH ≤ 20 mIU/mL (hormone testing) in the cycle of interest
3. Normal uterine cavity, as defined by the program
4. Normal ovulation without medication
1. Couples using donor oocytes
2. Couples using frozen embryos or oocytes
3. Any medical condition that is contraindicated to pregnancy or gonadotropin therapy (i.e. allergies, immune deficiency, etc)
What is natural cycle IVF?
Natural cycle IVF is in vitro fertilization, but just without the use of medications to stimulate the ovary to make multiples eggs. Patients are monitored in a natural cycle with ultrasounds and blood work to track the growth of the dominant follicle. An egg retrieval is then performed when the dominant follicle is determined to be an appropriate size. The egg that is retrieved is then fertilized in the laboratory in the same way as traditional IVF. If an embryo is produced and continues to develop, it is transferred back to the uterus, again in the same manner as conventional IVF.
Why should I be interested in natural cycle IVF?
Natural cycle IVF (unstimulated IVF) is an exciting alternative to traditional stimulated IVF cycles. It appeals to patients because it is low risk, has lower costs than stimulated IVF, and is patient-friendly. Natural cycle IVF offers patients the IVF process with fewer medications (meaning less cost and fewer injections), fewer side effects, and fewer office visits (all of which leads to less stress). Additionally, there is no risk of hyperstimulation and less physical stress on the body as a result of the minimal amount of medication taken. Also, natural cycle IVF minimizes the production of excess embryos and eliminates multiple pregnancies.
Is Natural Cycle IVF right for me?
For women considered “poor responders,” natural cycle IVF affords the opportunity to continue with the IVF process, even when ovarian stimulation has repetitively failed to produce multiple embryos.
For couples with infertility due to male factor (low or poor quality sperm), natural cycle IVF can provide an opportunity for fertilization through ICSI and at the same time avoid multiple pregnancies and unnecessary stimulation for an otherwise fertile female partner.
Women who cannot tolerate or do not desire to take hormonal therapy in order to conceive can still benefit from the IVF process.
Why are you doing this study?
Natural cycle IVF has recently gained worldwide attention as an alternative for both normal and poor responders. Though currently we already offer natural cycle IVF as a treatment option to our patients, we have not looked at the outcomes in a prospective nature and currently do not have enough patients who have recently undergone this type of treatment to make conclusions as to its ultimate effectiveness.
Will my medical care be changed by enrolling in the study?
Your medical care will not be changed in any manner by being enrolled in the study.
How can I find out if I qualify for the study?
Read the above stated inclusion and exclusion criteria. If you match all the stated categories for the inclusion criteria and don’t match any of the criteria that can exclude you from participating in the study, then most likely you can participate. However, you will need to make an appointment with one of the doctors to find out for sure. Feel free to contact the front office (213-975-9990) if you have a question about any of the inclusion or exclusion criteria and how they relate to you.
Will the cost of my treatment change because I am enrolling in the study?
Participants will be required to pay for all costs of the natural cycle IVF treatment cycle. However, the costs are less than those of a standard IVF cycle. Additionally, medication costs will be dramatically reduced.
How can I find out more information about the study?
The front office can assist you with some basic questions about the study. However, if you really want to discuss it in detail we suggest you make an appointment with one of our doctors for a consultation. You can also see our three-part blog on Natural Cycle IVF for more details, see our blog>>