Natural Cycle IVF Update

In two previous posts (Jan 9, 2008 and Jan 10, 2008) I discussed the use of unstimulated (Natural Cycle) IVF. Since 2007 we have been offering this option to our patients with the understanding that it is not going to be as successful as stimulated IVF for the majority of patients. Our prediction was that we could generate acceptable pregnancy rates in those patients with the best prognosis (younger, regular cycles, well-defined cause of infertility) and our data suggests that we have been successful.

However, our discussions with the leadership of the Society for Assisted Reproductive Technologies (SART) and the Centers for Disease Control (CDC) have been less successful. Currently the results from unstimulated and stimulated IVF are combined to yield a clinics IVF success rates as published in print and online as dictated by the Wyden Act that regulates the reporting of pregnancy rates by fertility clinics. Since maximum human fertility is 20-25% per reproductive cycle, there is no way that Natural Cycle IVF could yield a higher pregnancy rate than this level. So if you use Natural Cycle IVF on any patient whose stimulated IVF success rates should be >25%, then you will be shooting yourself in the foot as you knock down your reported pregnancy rates in order to offer this less expensive, less invasive option. This does not make for a hard decision when clinics consider whether or not to offer Natural Cycle IVF...

Hopefully, we will be initiating a study to evaluate physician attitudes concerning the use of Natural Cycle IVF in the US. In Europe and in many other foreign countries Natural Cycle IVF is used extensively, but not here at home where only a handful of clinics use unstimulated cycles to perform IVF. So if you want to see Natural Cycle IVF gain a foothold here in the USA, please keep asking your RE about this option!