We keep learning more about in-vitro fertilization (IVF) that guides our choices. The fertility industry is in constant motion and it can be hard to keep up. I wish I could clone myself and share all of my knowledge I have but I do what I can with my free time to post information like this. Here’s one on the difference between these two types of frozen embryo transfer (FET) protocols and the rise of the natural cycle because it’s timely.
Let’s go.
This topic is timely because of the increase in the number of natural FETs cycles offered at fertility clinics, and how programmed or medicated ones are occurring less often. They accounted for about 80% of FETs I would say, anecdotally. But, like anything with fertility, the question comes down to whether it’s right for you and your personal situation as opposed to whether everyone is doing it. It’s complicated which is indicative of the fertility world in general, an overload of choice, that can feel like you’re playing a game of chess-baseball-Russian roulette or something as stressful sounding. Information and context help (I hope!).
Natural or modified-natural vs programmed or medicated
A natural cycle requires less medication like the name suggests, often no estrogen supplementation (e.g. Estrace). The trade-off is that there are more trips to the lab to get a blood draw to keep checking that you don’t ovulate, and that the timing for transfer if just right. I’m choosing not to get into the details as much here so that we can stick to what impacts your decision more, so forgive the ‘quick and dirty’ description.
A programmed cycles involves more medication and more predictability but what we are learning is that there may be an increase in pregnancy complications later with this type of protocol; in particular, a programmed cycle seems to affect placenta development.
That’s not fun to learn about I’m sure.
Personally, I did a programmed FET that lead to my son’s birth but a significant postpartum haemorrhage requiring multiple blood transfusions in the process. If I could go back in time I might have opted for a natural cycle. But then, there’s no way of knowing if the transfer would have been successful. Also, I would have needed to factor in my age and PCOS.
Here in lies the dilemma, so I’ve outlined some factors for you to consider as if I’m speaking to myself in the past or a client in the present.
Factors to consider
What your fertility doctor recommends. If from reproductive endocrinologist (REI) recommends one, be sure to ask why. Probe to learn more. A reason could be that they are skilled at one type over another, you might prefer to go with the type they are skilled at (and might not be in your control which to choose).
Your period. If your periods are long, short, unpredictable, or irregular in any other way you might not want to do a natural or be a candidate for that matter. It means you could be going in daily for bloodwork for too long or ovulate so early that you miss the whole FET window. I personally have PCOS so for this reason I’d be less of a candidate with my irregular periods.
If you have an at-home ovulation tracking device like Mira or Inito. Sometimes these tracking devices can be used instead of daily bloodwork which can saves you that hassle. Usually using it for 3 months consecutively before is helpful. Some doctors don’t advice this or don’t allow the use of these and insist it must be bloodwork because there is room for human error. We humans aren’t perfect. Not that a blood test is, but much more likely to be correct.
Distance to a lab or the clinic and your schedule. Some people they live close a clinic or lab to get their blood drawn while others have to travel a long distances. This can factor in as well as if you’re working fuiltime and have the capacity for these daily blood draws and checks.
Other health markers like high blood pressure. If you’re looking to reduce your risk of preeclampsia and you already have indications that you’re at risk, a more natural cycle might be favoured if everything else is equal.
If you’ve experienced side effects to the medication in the past. If you find your response to medication like Estrace, Lupron and Letrozole aren’t pleasant, then that might inform your choice. Some people get migraines on increased estrogen, others are unaffected and even feel better on the increase.
If you’re already taking other medication in your protocol. If you’re doing a kitchen sink protocol you might require one protocol over the other.
Age or other health reasons. If you’re 35 or older and particularly 40 or older, you’re at increased risk of complications so that might impact your decision. Same for any other health reason that you want to avoid complications at all costs.
Let’s do this together
There’s so much more to this decision-making, but it can be an empowering process. Book a trial session with me if you want to explore more hands-on support. It’s confidential, non-judgemental and you get to decide when, and in your pajamas or on your commute home. It would be my pleasure to see how I can help.
