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What’s the difference between a natural and a hormone-regulated frozen embryo transfer?
If you are considering frozen embryo transfer (FET), there are two types to choose from: natural cycles and hormone-regulated cycles. Embryo quality and uterine environment play a significant part in the process. So, preparing the uterus is essential to ensure successful embryo implantation, which can increase your chances of achieving a successful pregnancy.
In a natural cycle, the woman’s menstrual cycle is used to help prepare the uterine lining for implantation. In contrast, the hormone-regulated cycle involved the use of medication to aid the process. However, both methods are effective and the choice depends on what works for you.
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What is a frozen embryo transfer?
A frozen embryo transfer is a procedure in which a previously frozen embryo is safely thawed and transferred into a patient’s uterus. This provides individuals with the opportunity to conceive without having to undergo another full IVF cycle.
A frozen embryo transfer may be recommended if you have completed a previous IVF cycle and were able to freeze a healthy embryo for future use. Alternatively, you may have frozen your embryo due to medical or personal reasons and are now in the position to use it.
Additionally, if you need to take a break from treatment due to the effects of hormone medication, a frozen embryo transfer can be a viable solution to help you conceive.
It’s important to understand that while a frozen embryo transfer doesn’t guarantee a successful pregnancy, it does allow you to preserve your fertility, and gives you the chance to have children when you are ready.
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What’s the difference between a natural and hormone-regulated transfer?
Both natural and hormone-regulated transfer are equally effective, however, the choice between them depends on your fertility health. Rest assured, our fertility team will discuss this in detail during your consultation.
A natural cycle requires no medication and is recommended if you have regular monthly cycles. This process relies on your body’s natural menstrual cycle to prepare the uterine lining. In contrast, a hormone-regulated transfer cycle uses hormonal medication, including oestrogen and progesterone, to temporarily stop the function of your ovaries and thicken the lining of your uterus. While some may argue that a hormone-regulated transfer is more predictable in terms of transfer timing, a natural cycle requires no medication, potentially leading to fewer complications. However, we will discuss your options in detail during the consultation and decide the best course of treatment for you.
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How does a natural embryo transfer work?
If you have regular menstrual cycles or experience luteinizing hormone (LH) surge, which triggers ovulation, a natural cycle may be recommended for you. However, it is important to understand the process of a natural embryo transfer.
Step 1: Consultation
You will be scheduled for your first consultation, where we will discuss the process with you in detail. You will have to sign consent forms, ensure you are taking pre-conceptional vitamins and if using luteal support ensure you have this on your prescription.
Progesterone luteal support involves supplementing hormone production by the corpus luteum, which is where you ovulate from. It also aids growth factors and hormones that may be beneficial for establishing a healthy pregnancy.
Step 2: Fertility tests and scans
Once you are booked for treatment, a scan will be arranged around day eight of your menstrual cycle to assess the thickness of your uterine lining and to check for follicle development. If everything is okay, no further scans will be required.
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Step 3: Once the endometrium has reached a certain thickness and a dominant follicle has been identified, you'll need to do LH testing at home using ClearBlue LH kits morning and evening. Once there is a clear LH surge, you will be asked to contact the clinic, and you will be scheduled for your frozen embryo transfer six days later – LH surge is classified as day 0.
It's essential to understand that in approximately 10% of cases, no ovulation will be detected, or there may be no follicle development. If this is the case, you’ll undergo a hormonal-regulated controlled cycle the following month.
What happens on the day of the transfer?
On the day of your frozen embryo transfer, you'll need to arrive at the fertility clinic with a full bladder. Our embryology team will have thawed your embryo, depending on its quality, ensuring they are ready for transfer to take place.
The embryo will then be transferred into the uterus using a soft transfer catheter, which will be safely guided through the cervix and into the uterine cavity. While you may experience mild cramping or discomfort during the procedure, it’s generally not painful.
The entire process usually takes less than five minutes and you’ll be able to go home straight after your appointment.
Some individuals may choose to have additional luteal hormonal support following the embryo transfer, but this will be discussed with you beforehand.
Reviewed by Stacey Rohling, Senior Fertility Nurse at TFP Oxford Fertility.
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