Natural IVF Vs. Mild IVF: Choosing The Right Fertility Treatment

BySharath P Devdas
Natural IVF and Mild IVF

Both natural and mild IVF are different from conventional IVF treatment in their approach. While natural and mild IVF treatments are focused on improving fertility alongside the natural menstrual cycle, conventional IVF utilizes medications to halt the natural menstrual cycle and initiate fertilization. Even though the decision to pursue fertility treatment involves personal, medical, and financial considerations, it is wise to know about the available options. In this article, we will explore what natural and mild IVF are, their pros and cons, and who can benefit from these treatments.

Natural IVF

Natural IVF is a fertility treatment that collects eggs aligned with a woman’s natural menstrual cycle without the use of stimulating medications. This means only one follicle will develop and produce a mature egg per menstrual cycle. Patients are monitored with bloodwork and ultrasounds to track the development of the egg to avoid its release before it can be retrieved.

procedure for natural ivf

It is then retrieved, harvested, and fertilized in the lab, similar to the conventional IVF method. If the embryo developed is viable, it will be transferred back into the woman’s uterus. Natural IVF is often addressed as medication-free IVF, but the woman may need daily injections to prevent early ovulation and small amounts of gonadotropin to support the egg’s growth.

Benefits:

  • Eliminates the risk of ovarian hyperstimulation
  • Eliminates stimulating injections and drugs
  • Safer and shorter fertility treatment
  • Less expensive and less stressful
  • Timed with the natural menstrual cycle, therefore no downregulation (the process where the menstrual cycle is shut down and restarted in conventional IVF)
  • Easier and faster egg retrieval
  • Higher quality eggs

Drawbacks

  • As the treatment does not incorporate stimulation drugs, there is a high chance of premature ovulation or missed ovulation. Such incidences are reported in over 10 to 15% of the natural IVF cycles.
  • With only one egg, there is only one chance for success. So, if the egg produced is unhealthy or does not get fertilized, the cycle gets terminated.
  • The injections that are used to delay ovulation, frequent checkups, surgical egg retrieval, in vitro fertilization, and implantation are still involved in natural IVF and are still costly.
  • Natural IVF has lower success rates than conventional IVF treatment. One may have to undergo several natural cycles to get a positive result compared to one stimulated IVF cycle.

Ideal candidates:

  • Women under 37 years old (considering that their fertility and egg quality deteriorate as they approach menopause) who are naturally ovulating and are unlikely to recruit more than one egg are ideal for natural IVF.
  • When a woman has already undergone several attempts at conventional IVF but has not benefited from it.
  • Women with concerns over the side effects of stimulating medications or with a medical condition where stimulation is not possible can also go for natural IVF.
  • Women with low anti-mullerian hormone (AMH) and high follicle-stimulating hormone (FSH) are also said to benefit from natural IVF.
  • Women with medical conditions like PCOS would not benefit from natural IVF as they have irregular cycles and a very high ovarian reserve.

Mild IVF

Mild IVF, or mild stimulation IVF, is similar to natural IVF as it works alongside the woman’s natural menstrual cycle. However, it is different from natural IVF treatment as patients are given stimulating drugs to produce at least 2 to 10 eggs. The dosage of these medications is lower and shorter than that of standard IVF. Women who undergo mild IVF will first complete a 5- to 9-day course of mild stimulation drugs. The rest of the procedures are the same for both natural and mild IVF.

Benefits:

  • Only small doses of oral or injectable stimulating medications are needed. Hence, you will not experience the side effects that accompany excessive levels of stimulating hormones.
  • It presents reduced risks of hyperstimulation syndrome.
  • We could retrieve at least 3 to 5 high-quality eggs, allowing a better chance of developing a healthy embryo.
  • Shorter overall treatment process with no downregulation
  • Lower costs compared to traditional IVF
  • Recent research has found that the success rates of mild IVF are comparable with those of the traditional or standard IVF procedure.

Drawbacks

  • Even though the doses are low, they do introduce stimulants into our system.
  • It produces fewer eggs compared to traditional IVF, so there are only fewer embryos to transfer.
  • Costs will still include checkups, lab work, egg retrieval, fertilization, and embryo transfer. If multiple cycles are required, the treatment will get more expensive.

Ideal Candidates:

  • Mild IVF can benefit women who do not respond to injections or have low ovarian reserves.
  • It is suitable for women with other medical conditions where the risk of OHSS needs to be minimized.
  • It is an ideal choice for patients who have concerns about the high doses of medication needed for conventional IVF.
  • Mild IVF is suitable for individuals who are in a relationship with only male factor infertility.
  • This can also benefit women with PCOS who are at higher risk of developing ovarian hyperstimulation.

Bottom line

Mild and natural IVF provide paramount importance for women’s health; hence, they use fewer drugs and have fewer side effects. On the contrary, conventional IVF exposes patients to a higher risk of developing medical conditions like ovarian hyperstimulation syndrome and various other complications. Additionally, natural and mild IVF work along the woman’s natural menstrual cycle, unlike traditional IVF, which stops it before restarting the cycle.

In the natural IVF cycle, no drugs or injections are used to stimulate the growth of follicles in the ovaries, and therefore, only one follicle will develop and provide a mature egg. However, in mild IVF, a low dose of drugs is given to the patients to stimulate several follicles, producing at least 2 to 10 eggs in a cycle but not as many as with the conventional IVF cycle. Whether you need mild IVF, natural IVF, or conventional IVF is solely based on your individual circumstances. Your doctor will determine which is best for you after a deliberate examination of your reproductive and overall health.

Dr. Sharath P Devdas is a highly skilled fertility specialist and gynecologist with a passion for providing the best care to his patients. He completed his MBBS from Universal College of Medical Science (Tribhuvan University) and pursued further specialization with a Fellowship in Reproductive Medicine (FRM). With over a decade of experience in the medical field, Dr. Sharath has earned a reputation as one of the country's finest practitioners in his field. He currently serves as the director and chief consultant at Fertility First IVF Centre, where his compassionate approach and vast knowledge create a sanctuary for his patients.

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