FET - natural vs medicated cycle

[AliciaWhiskers]

Our first round of ICSI (short protocol) failed, and we have 1 blast in the freezer (graded 4AB).

Went back for follow up today and discussed a FET cycle. Our clinic only do a medicated cycle, which is long protocol. We could do a natural cycle with the clinic where our embryo is frozen if we wanted to.

I don’t know much about frozen cycles and which would be best in our situation. I’m 40, DP 44, I have PCOS but have regular cycles, although my LH and FSH results were both high. We are self funding, and I’m not sure if we will do another fresh cycle if this doesn’t work, as DP had 4 failed cycles with his ex as well.

WWYD? Medicated or natural?

I did natural as I don't like the idea of switching things off (like ovaries!) - I suppose im scared they won't come back on.

They are much easier and quicker as you just test for normal ovulation and have a couple of scans tracking the largest follicle. My clinic are happy to do it though because my cycles are like clockwork and also lining thickness is always perfect - If i didn't have either of these then I would have done medicated

I did a medicated FET as by that point I didn't have much trust in my own body even though I had regular cycles and ovulated I liked that the hormones were controlled. I have unexplained so i felt I needed some help. I found it pretty easy, not a lot of monitoring, actually quite boring compared to a retrieval cycle.

I did natural with a scan and some bloods to make sure timings were correct. Was really straight forward and worked. I was keen on this cos it was quicker! Hate all the faffing around waiting as I’m really a just get on with it person.

If your bloods suggest everything is fine don’t see why clinic wouldn’t do this.

@Waterdropsdown apparently my clinic just don't do natural cycles. They used to, and ended up with a lot of women then needing to be medicated, so they don't do it now. Also, when you say if my bloods suggest everything is fine, which bloods do you mean?

@LillyLeaf I know what you mean about not trusting your own body. It feels like if I did a natural cycle and it didn't work, or my body did something weird, it would be my fault for it not working. With a medicated cycle, that would be somewhat out of my control. Did you do the long protocol for the FET?

@itwasalovelydreamwhileitlasted totally get the worry about switching stuff off and worrying it might not switch on again!

I'm not sure if it was classed as long or short protocol but I started Buserelin on cd21, then had a bleed then baseline scan and when they happy my lining was shedding I started Evorel patches then did a transfer on cd21, also started progesterone 5 days before transfer. Looking at my calendar I had 3 scans and a few blood tests before the transfer. It was pretty easy going.

I did a natural cycle. According to my clinic the success results are the same it’s just that some people like to plan and know when everything will happen (which you can do on Medicated cycles) natural cycles are less predictable.

I can see that it’s easier for the clinic to plan timings etc if medicated. This is often the way things work on the NHS but weird you can’t choose when you are paying for it.

Bloods were to monitor for ovulation. I forget when they started but probably about CD10 or so then they did a blood test every couple of days to confirm ovulation so they know which day to put the embryo back in (as it would be a blastocyst under normal circumstances by ovulation +5 days so they need to put it back at the right time).

I had a medicated fet! It was fine a few scans here and there! Started buserelin on day 21 it did delay af for a week and suffered with some hot flushes but once they had checked my lining had shed started progynova and once my lining had been checked to make sure it was thick enough stopped the buserelin and started in the progesterone 5 days before transfer!

Am just waiting for af to arrive so that I can start my second medicated fet on day 21! First one resulted in bfp but ended at 5 weeks!

The clinic where our frostie is being stored say they hardly do any natural FET cycles, so they have no stats for the success rates. They said that for a medicated cycle the success rate is 20%. That sounds so low! Is that normal?!

@FinallytakingtheplungewithIVF best of luck for your next cycle. That protocol sounds the same as what has been suggested by my clinic (pretty much, anyway)

@Waterdropsdown the clinic I am going to just doesn't do natural FET. She said that they used to, and had so many that they then had to transfer onto medicated that they just stopped doing them.

Heya I know this thread was way back last year.. I'm in the same position, I lost one back this year through a medicated cycle I could of had natural but the ovulation sticks was hard to get on with and said I was ovulating constantly, so went for a medicated cycle, which ended in miscarriage, after this I was told to do a natural cycle but with scan monitoring, to be told my lining wasn't ready so cancelled then even tho I picked up ovulation with a smiley face this time my follicles are smaller, so was told to them take a blood test to see if I did end up ovulating, if I did I would go ahead this cycle and trust the ovulation stick.. but I'm now worried and thinking should I just go for medicated again..

Just wondering. What everyone's thoughts are

I'm in this position too... my first FET turned into an ectopic. Second FET attempt (also medicated) was cancelled as I didn't response to the oestrogen - my lining only made it to 6mm and I developed a large follicle which should have been suppressed. Wondering if I'd respond better to my own oestrogen... has anyone got experience of this? I'm pretty good at pinpointing ovulation with OPKs but aware there is likely to be more monitoring and there is a risk you might 'miss' ovulation' and have to abandon.

@bicyclesandbeyond hey. Thank you for responding.. this is the thing I've had 7 scans now 3 from a cycle where my lining wasn't ready, then this cycle where follicles wasn't ready even tho I picked up on ovulation they said we couldn't go a head.. they said they would do blood test to see if I did ovulate and if I did the would take my sticks word for it next time which worries me cause this time round they won't monitor me just go by the sticks. And after all these complications I'm worried about doing this on my own an not help with medication or scans jsut going in blinded.. it's so hard knowing what to do.

That sounds really confusing @ivftake3 - it was my understanding that they use a combination of sticks, scans and blood tests to pinpoint ovulation and then transfer 5 days later. Did your scans show that you ovulated but that your lining wasn't thick enough? I've got a Consultant appointment on Monday to discuss natural v medicated and will report back if it's helpful! Where have you left it with your clinic? Could you have another consultation to discuss?

Rereading your posts it seems like medicated might be best for you? You obviously responded well to the oestrogen, and the clinic would full control over transfer day? I'm sorry your last one ended in miscarriage though xx