What is Natural Cycle IVF?
Natural cycle in vitro fertilization treatment is a preferred assisted reproductive treatment method in cases where ovarian reserves are limited and no more than three oocytes have been obtained in past treatment histories.
The advantage of natural cycle IVF is that the cost of medication is quite low. When the structure called the follicle, which is thought to contain the oocyte, or egg, reaches a certain volume with ultrasound monitoring, a large amount of stimulating hormone and drugs called antagonists that will prevent the follicle from rupturing on its own are applied to try to provide oocytes.
The difficult part is that it is difficult to obtain oocytes at each follow-up stage. For this reason, treatment may not be continued until the transfer stage. According to some data, it has been stated that pregnancy can be achieved with a rate of ten percent.
Instead, a few eggs can be obtained in a very short time and with very few injections by using a light stimulation method, that is, by applying a low dose of hormones. In this way, the possibility of the follicles bursting on their own and not being able to provide eggs is reduced. The expectant mother is protected from using high dosages of medication for periods that do not increase the possibility of pregnancy and can be quite boring for the person.
Why is natural cycle IVF applied?
Because IVF treatments are a financial burden for prospective parents, reasonable and easy methods are being developed in addition to the known and commonly applied treatment methods. One of these is the drug-free (natural) IVF treatment method.
A significant portion of the cost of IVF treatment is covered by the drugs used to develop eggs. These drugs can vary from patient to patient, but they cost around 1000-2000 TL. In expectant mothers who develop more than one egg with high doses of drugs, the number of embryos that can be transferred increases. For this reason, the risk of multiple pregnancy increases, but the rate of pregnancy also increases. For this reason, high doses of drugs are used as a standard treatment method in all countries of the world.
However, no matter how high the dose of the drugs, there are also patient groups that do not respond positively to these treatment protocols. In expectant mothers with normal menstruation, one egg may develop in natural cycles, but in this patient group, despite all the treatments applied and all the drugs used, it may not be possible for more than one or two eggs to develop. In addition, the quality of these eggs is often not as desired. As a result, the probability of fertilization is low, and in patients who undergo transfer, the probability of pregnancy is low. These are especially seen in patients close to menopause and those with premature ovarian aging. Applying known treatment methods to this patient group will not be useful. In these patients, taking the egg that develops on its own without applying any medication and fertilizing it with microinjection is the treatment method called in vitro fertilization treatment in natural cycles. Since there is no medication used, this expense is not there or is kept to a minimum, it is a more preferable option for this group of expectant mothers.
Only in the natural cycle does the body's own egg-cracking system work. For this reason, it is very difficult to determine when the egg is ready to be fertilized. Sometimes, during the planned egg retrieval process, it may be noticed that ovulation has already occurred. This means that eggs cannot be retrieved for the microinjection process.
In order for the egg collection process to be carried out and a healthy, usable egg to be obtained, the egg must have reached a certain level of maturity but must not have cracked.
In the natural cycle, when the egg reaches a certain size, the LH hormone level, which stimulates ovulation, increases and causes the egg to reach its final maturity and crack. However, the time when the LH hormone rises should be followed very meticulously. An ideal tachycardia can be performed by administering hCG medication after the egg reaches an average volume of 17 mm, before the LH hormone rises. If the LH hormone rises on its own before this time, then egg collection can be performed before 24 hours have passed by learning when the hormone reaches its highest level. If egg collection is performed early, an immature egg will be collected and the probability of success in the treatment will decrease significantly. Conversely, if collection is delayed, the egg will have cracked.
In natural cycle ICSI applications, the probability of pregnancy is only at a certain level. It is possible to achieve pregnancy with a rate of up to 15% with natural cycle ICSI application. However, this rate represents the pregnancy rate achieved for mothers who undergo embryo transfer. Approximately 60-70% of mothers who start treatment can obtain eggs. In addition, not every egg is of good quality, and therefore fertilization does not occur. However, an average of 40-50% of mothers who start treatment can obtain embryos that can be transferred.
In conclusion, despite the limited chance of success in natural cycle ICSI application, it is an easy, practical and less costly alternative assisted reproduction method for mothers and fathers who want to continue the possibility of treatment. The natural cycle application alternative is definitely a method that should be tried for mothers with low ovarian reserve.
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