Natural or medicated frozen embryo transfer


I am a 36 year old woman ttc for 6 years with 2 previous failed IVF cycles, though both initially resulted in pregnancy. For the first I had a 'chemical pregnancy' - ie initial positive test very quickly followed by a negative result. The second cycle resulted in a positive test, then heartbeat seen at scan at 7 weeks, however no hb at 8.5 weeks and so I had a medically managed miscarriage. Genetic analysis showed a chromosomal anomaly of the embryo (doubling of the 4th chromosome) with nothing further uncovered with regards to myself that would cause multiple miscarriages. I have earlier had one spontaneous pregnancy (in 2010) which ended in missed miscarriage picked up on 10 week scan (again after seeing earlier healthy heartbeat)

I have multi-follicular ovaries (but not PCOS) and developed moderate OHSS requiring hospitalisation for my first IVF round. The upside of that is that I now have 9 good frozen blastocysts for use in future FET.

I have a regular 29-31 day cycle and every investigation I have had indicates I am ovulating normally. My husband has great sperm count with no diagnosed problems and our diagnosis is 'unexplained infertility' with me also having had a small amount of endometriosis treated laparoscopically in the past, not thought to be particularly significant.

My question is whether you would recommend natural or medicated FET?

My clinic lean heavily towards medicated because it makes it easier for them to schedule patients, but I do not see this as a valid enough reason to determine the best course of treatment for an individual, and am ready to change clinics. However so against natural cycles are they that they will not even discuss the relative benefits and drawbacks of each or even outline in detail what is involved in each course of treatment. Could you kindly fill me in on this in your opinion?

I would also be very interested to know if there is any kind of 'middle way' - where for example my bodies rhythms may be able to be followed, and ovulation able to occur so that I have a corpus luteum to support any pregnancy, but with appropriate medication to support/supplement the process?

Many thanks!

Our Expert's Answer

This information was published 10 years, 7 months ago and was correct at the time of publication. It may not reflect our current practices or regulations.

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

When we studied the results from medicated or natural frozen embryo transfer cycles we did not find any difference in success rates between the two treatments.  Unless there is a medical reason to use hormone control we recommend natural cycles for our patients just because it is more cost effective.  We also do not advocate luteal support unless there is a genuine reason for this.