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Natural cycle IVF
For some people, mild and natural IVF offer a way forward without high doses of fertility medicines.
We’re experts in all types of IVF, with more than 35 years of experience helping make families. We can guide you through your options, making recommendations that are grounded in evidence and with your best interests at heart.
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What is natural IVF?
IVF (in vitro fertilisation) is one of the most common types of fertility treatment, following several steps. In traditional IVF, you'll encounter a stimulation phase which involves using fertility medicines to encourage multiple eggs to grow at once. As a result, you can collect a group of eggs at the same time.
In natural IVF, you'll follow most of these same stages, however, you will not use fertility medicines to stimulate your egg growth. As a result, we only retrieve the single egg produced by your natural cycle.
Similarly, mild IVF uses lower doses of stimulation medicines compared to traditional IVF, resulting in a smaller number of eggs.
These are the steps you'd typically follow with natural IVF.
Step 1
Tracking your menstrual cycle
We'll book you in for a follicle tracking scan prior to your expected ovulation day. During the scan, one of our specialists will assess the development of your follicle, which are fluid-filled sacs where the egg grows.
Step 2
Trigger injection
Once your follicle is large enough, you'll need to have your trigger injection. This causes final maturation of the egg, like traditional IVF. You take a quick and easy trigger injection, and the egg is collected around 36 hours later.
Step 3
Egg retrieval
We use an ultrasound scan to locate the egg, which is captured by gently passing a needle through the vagina and in to the follicle. The whole process takes around 15 minutes, though you can expect to be with us for a few hours while we prepare you and help you recover.
Step 4
Fertilising the egg
Your egg is then mixed with the sperm of your partner, co-parent or donor and left to fertilise naturally in the lab. In some cases, particularly where there is male factor infertility, we may recommend a procedure known as ICSI where a single sperm is injected directly into the egg.
Step 5
Embryo development
Your fertilised egg, now an embryo, is incubated for up to six days. When it reaches the blastocyst stage, we check under a microscope to see whether it’s suitable for transfer, based on a grading system. You can also choose to have pre-implantation genetic testing (PGT) which screens for any genetic faults.
Step 6
Embryo transfer
With natural IVF, the embryo is transferred back inside your womb five days after egg retrieval. Embryo transfer is a relatively simple procedure during which the embryo is gently placed inside the womb with the hopes of successful implantation.
What are the benefits of natural IVF?
Is it safer?
The main benefit of natural IVF is avoiding potential downsides of fertility medicines – the risks and side effects.
Most people taking gonadotrophins for stimulation have mild to moderate side effects, which can include:
Headaches
Tiredness
Hot flushes
Tender breasts
Feeling low or irritable
Ovarian hyperstimulation syndrome (OHSS)
For around 1 in 100 people having IVF, OHSS is severe and can be a life-threatening condition
During traditional IVF, we carefully monitor your dose and reaction during the two-week stimulation phase. If needed, we adjust the dose to help avoid uncomfortable and serious side effects. But mild or natural IVF is another option for those looking to reduce the risks even further.
Does it produce better embryos?
Some doctors believe that mild or natural IVF gives more high-quality embryos.
There's no strong research to suggest that IVF medicines harm developing eggs or lead to low-grade embryos.
More research is needed to understand how the type of IVF interacts with individual factors, including:
Age
Being a high, medium, or low responder to IVF
Ovarian reserve
A few studies have suggested that in low responders, a mild protocol can achieve the same number of high-grade embryos as high-dose IVF.
Is it cheaper?
You may also hear that natural IVF lowers the costs. This can be the case for an individual cycle, but it might not lower costs overall.
When having natural IVF you can avoid some costs, including:
Stimulation medicines
Additional scans and appointments to monitor medicine response
Egg freezing during recovery breaks
However, because you'll produce fewer or only one embryo, you won't be able to have any surplus embryos frozen. This means if implantation is unsuccessful, you’ll need to do another fresh egg retrieval cycle to try again.
In traditional IVF, many embryos may be frozen in a cycle. If you have enough high-grade embryos, you can try implantation again without another round of egg retrieval.
Over time, the costs of repeat retrieval with natural IVF can add up, meaning you may not feel the benefit of the cost savings per cycle.
Is it faster?
It's impossible to say how quickly any one person will become pregnant with fertility treatment. But one benefit of natural IVF is that you don't need to take long breaks.
In traditional IVF, the womb lining (endometrium) may need time to replenish with a natural cycle before your transfer. This can mean freezing your embryos for two or three months. You'll also need to take breaks in between IVF attempts.
Who is natural IVF for?
Some people may want to avoid fertility medicines, such as down-regulating medicines, gonadotrophins, and GnRH.
This could be because:
You have a higher risk of OHSS
You've had or have an oestrogen-sensitive cancer
You want to avoid uncomfortable side effects
You want to avoid freezing or destroying any extra embryos
Deciding the right protocol and dose of IVF medicines is a fine balance. It comes down to several individual factors, including your medical history, ovarian reserve, and egg quality.
The best person to advise how you might respond to different types of IVF is a fertility specialist. They're familiar with your specific circumstances and can give personalised recommendations.
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Natural IVF success rates
Generally, the success rates for natural and mild IVF are much lower than with traditional IVF, according to the HFEA. The main factors thought to influence the success of natural IVF are your age and duration of infertility.
We share success rates for traditional IVF on each of our clinic pages. You can discuss with your consultant how natural or mild IVF are likely to influence your treatment journey and chances of success.
What is the difference between high-stimulation and natural IVF?
The main difference between the protocols is using gonadotrophins during the stimulation phase, also known as follicle stimulating hormone.
A high-dose IVF plan usually means having more than 150 units of gonadotrophins a day. Mild IVF uses lower doses, and natural IVF is completely free from stimulation medicines.
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