Natural Cycle IVF
Natural Cycle IVF is an ideal treatment where there is significant fallopian tube disease. The Natural Cycle IVF avoids the stimulation of the ovaries and all of the risks and side effects that go along with that stimulation.
The ideal candidate for Natural Cycle IVF has the following:
- Age less than 35
- Tubal Infertility
- No major sperm problem
- FSH less than 8 miu/ml and estradiol less than 50 pg/ml (cycle day 3)
- Normal AMH level (anti-Müllerian hormone)
- Normal Uterus
The Natural Cycle IVF is available to most patients, but if they fall outside of the criteria they will have a lower success rate.
Process of Natural Cycle IVF
In a regularly ovulating woman, the egg usually releases 12-14 days before the menstrual period starts. Careful monitoring is done to time the natural cycle for an egg retrieval before the egg releases spontaneously.
1. Follicle Monitoring
After the menstrual period begins, the woman will come into NOVA for an ultrasound and possible hormone blood test to verify that she is ready to be monitored for her cycle. A return visit is then arranged to evaluate the development of the dominant follicle. Once the dominant follicle reaches the appropriate size and the estradiol level is high enough, a trigger shot is given to mature the egg and time the egg retrieval.
2. Egg Retrieval
Thirty-five to thirty-seven hours after the trigger injection, an oocyte retrieval is done in NOVA. This is typically is a 1-2 minute procedure. Eighty percent of the time the egg will be retrieved. Using ultrasound guidance, a thin aspirating needle is passed through the top of the vagina into the follicle. Only the tip of the aspirating needle enters the pelvic area. Since the ovaries are located just above the top of the vagina, the tip of the needle is passed into the follicle without penetrating the uterus, cervix or the fallopian tubes.
The sperm (~ 50,000) will be added to a droplet containing the egg. The fertilization process takes place over night.
The next day, NOVA’s embryologist will examine the egg for signs of fertilization. A normally fertilized egg (zygote) will show two pronuclei representing the genetic material from the egg and sperm (first image below). Eighty percent of the time fertilization will take place.
The following day, the best embryo will reach the 4 cell-stage, the day after, 8 cells and by day 5 after egg retrieval, they should reach the blastocyst stage with over 160 cells.
4. Embryo Transfer
Two to three days after the egg retrieval, the resulting embryo is transferred into the uterus by passing a thin embryo transfer catheter through the cervix to the top of the uterus. This procedure is always done under ultrasound guidance. This dramatically increases the chance of the embryo implanting and causing a pregnancy. Sometimes the ultrasound will be transabdominal and other times it is better to use the transvaginal ultrasound. Regardless of the ultrasound method, embryos are never “blindly” placed into the uterus.
5. Establishment of Pregnancy
Progesterone vaginal capsules are given for luteal phase support. A blood pregnancy test is scheduled approximately two weeks after the embryo transfer. A fetal heartbeat ultrasound is done two weeks after a positive pregnancy test.
This ultrasound picture shows an eight week pregnancy. The baby inside the sac is about an inch inch long, yet it is possible to already distinguish the head and the bottom portion of the baby’s body.
The natural cycle includes ultrasound monitoring and hormone determinations to precisely time the “trigger shot” for ovulation and the egg retrieval.
The Natural Cycle IVF fee is $6,200. This fee includes the following services:
- All in-cycle office visit(s) and ultrasound examination(s)
- Hormone testing in the cycle
- Egg retrieval
- Anethesia and procedure room
- Preparation of semen for IVF
- Culture of embryo until transfer
- Embryo Transfer
- Serum pregnancy test(s)
- Pregnancy ultrasound(s)
Fees are subject to change without notice.