Tuesday, February 15, 2011

Doctor Cancels IVF Cycle Despite Follies Being Present: Can Patient Go On To Do A "Natural" IVF Cycle?

This is a pretty simple question - started IVF cycle with micro-dose lupron after 10 days on the pill (for the dr.s convenience) Follistem and menopur. I stimmed for 4 days then cancelled due to only having 3 follicles and low E2.

My question is, my period is due soon. Can I jump right in and re-start the process? This go around will be a "natural" cycle. I respond much better when it correlates to my body's natural timing. We have an issue with age and I hate to put it off another whole month.

Thank you! A. From Illinois


Hello A. from the U.S.,

First let me say that using the birth control pill is NOT just for the doctor's convenience. After many many years of doing IVF worldwide, it has been shown to help increase the chances of success and helps to control the ovary better. Timing is critical with IVF so it especially helps with timing.

Yes, natural cycle IVF can be done and there are some (a minority) of specialists that think this works better in low responder or older patients. But if that were the thinking then why cancel a cycle? I am not one of those "believers" and I don't cancel cycles. Even if I have only one follicle, there is no way for me to know that that one follicle doesn't have the perfect egg that only comes up once every several months. Why should I waste the opportunity? I have had many pregnancies with only one follicle and one egg.

You certainly can go directly into another cycle using your natural period as the start point. You will need to check with your doctor about that, but physiologically there is not reason to not do that except if a persistent cyst is present. Sometimes, if ovulation has not occurred, you can have a persistent cyst that will cause dysfunctional bleeding and trick you into thinking that you are having a natural period. It just needs to be checked for at the beginning (CD#2) of the cycle.

Good Luck,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

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