Natural or medicated FET- help!

[Natty2]

Hi all, I wondered how you got on with your FETs and whether you went for medicated or natural cycles?

I had a follow up consultation from round 2 ivf
First cycle in Jan resulted in 1 embryo which was frozen due to high progesterone
Decided to proceed with second round in March which resulted in 7 embryos but all frozen again due to risk of OHSS

Our clinic was previously adamant that we had to wait for 3 months before FET. After yesterday's consultation they've said I can now start next month (second bleed post EC) and they've suggested natural for me, but I have a choice

I'm confused at the moment because I wasn't expecting to be allowed to do this next month so inclined to go for natural as I've done two back to back ECs, so maybe a rest from meds would be good, but understand the uncertainties reg. timings etc

How many people with natural have had to have it cancelled?

Let me know your experiences with natural or medicated rounds please, I'll be grateful to hear more!

Hi,

I had a failed fresh transfer. I did my first unmedicated FET (only trigger shot taken) and it went fine! I got a positive after. It was great for my body to rest after the EC - and I think the lack of hormones/injections/stress may have helped me.

I will say that I had to go for scans twice a week for 3 weeks - it took forever to get to the right stage - and then it was suddenly time within 24 hours. I ovulate late, so it might be less scan-intensive for you. It was a bit stressful, but the doctors were good about making sure they didn’t miss ‘the window’. I didn’t always trust them, but they got it right judging by my positive!

If you have 8 embryos, I’d say give natural a go first time round.

@Copenhagener congratulations on your bfp! I think we started our Jan ivf round around the same time. Great to hear your positive news ☺️

Congratulations @Copenhagener !

@Natty2 I've had 2 fully natural FETs (mainly because there's a lower risk of preeclampsia, which I had with my previous pregnancy) and they were really straightforward. One scan on CD9 or 10 in which they checked my lining and the size of the dominant follicle (both times everything was OK at the first scan so didn't need any others), then tested at home for ovulation, started progesterone pessaries the day after the positive ovulation test, and went in for transfer 5 days later. The first FET failed and I'm waiting to test again, so no positive news yet in that sense, but both times were so, so much easier than my fresh transfers and my body felt a lot better than being on any medication.

Best of luck!

I am a big advocate for natural FET. I had IVF due to being in a same sex marriage so no fertility issues per se and I always worried that the mimicking of a cycle never worked as well as my natural luteal. I had 2 x medicated FET that resulted in a negative result. Pushed for natural as felt the implantation window would be better without the meds and first FET resulted in BFP (sadly a missed miscarriage due to chromosome issues) and second natural FET resulted in current pregnancy (currently 8+3 and everything looking good on scans so far).

With my natural FETs, I always used a trigger once dominant follicle reached 16-17mm and lining >7mm and transfer was scheduled for 7 days later (5 days from ovulation). I also didn’t start progesterone until after a positive HPT as I was paranoid that it would alter the natural implantation window. That worked for me, but I know standard protocol is to add progesterone from ovulation for luteal support. I am still on 3 x cyclogest a day until 16weeks.

if you’ve been through a lot medication wise (I also had OHSS…it’s no fun) then I would go ahead with a natural FET, particularly as you have a good number of embryos. It’s also positive that your clinic see this as a good option for you.

Good luck 🍀

@beachbum85 thank you for your advice, and best of luck this time has gone well for you!🤞

@GB844 I'm sorry you went through so many FETs, congratulations on your BFP! That's really helpful to know your experience with a natural cycle

Thank you @Natty2 ! OTD today and we got our BFP so I can advocate for a natural FET more strongly now ☺️ best of luck to you for your transfer 🤞🏼

@beachbum85 wonderful news!! Huge congratulations to you 💛

Hi @Natty2 came across this and was very intrigued as my natural FET was even more hands off.

I had a fresh cycle four years ago which resulted in my DS and 2 frozen blastos. In our initial consultation for the 2nd I had a scan where the head nurse checked by ovaries, uterus and lining which were normal. I then had to do a test cycle where I used at home ovulation sticks, and had a blood test to check my progesterone levels a few days after ovulation (can't remember what they were but they were good). The next month I just did the at home ovulation tests, and after I got a positive, I was booked in for the transfer 6 days later. No additional scans or anything I just showed up on the day. I got a BFP when I tested day 10 post transfer, and am now just over 5 weeks. I've also not had any progesterone. The nurse explained that as my levels were good it wasn't necessary unless I really wanted to.

I agree with others that if if appropriate for you natural is a good option. This study (link below) showed no difference in outcomes: Natural cycle versus artificial cycle in frozen-thawed embryo transfer: A randomized prospective trial - PMC (nih.gov)

Hope that helps.

@Rose301 congratulations! This sounds really positive, thank you for sharing. I know everyone is different but natural seems like the right way to go for this first round. Normally I would like to have control over what happens, and although there's uncertainty I have a strong feeling that I need to lay off the meds for a little while after the back to back ECs.
I have nurse planning tomorrow so hopefully will lock in a plan.

@Natty2 thank you. Hope your appointment goes well. I’m a strong believer in listening to your gut! Best of luck