With a follicle size of 18 mm, either under the control of an ovulation test, or after the intramuscular injection of an ovulation trigger, a follicle is punctured to obtain an egg. The rest of the IVF program process remains the same.

To increase the effectiveness of IVF, the program includes the study of egg’s spindle apparatus.

IVF in the natural cycle: pros and cons

The reason for the low demand for IVF in the natural menstrual cycle is that it is characterized by a fairly low efficiency. The pregnancy rate is lower than with insemination in the natural cycle, it is about 7% in terms of each started cycle.
This is due to the fact that not every mature follicle is an egg carrier. In addition, because of the puncture, only one egg is extracted, which may not be able to fertilize. Also, when using this method, there is a risk of canceling the oocyte collection procedure due to premature ovulation.

The advantage of this method is to minimize the risk of complications such as ovarian hyperstimulation syndrome.

The undoubted advantages of the IVF method in the natural cycle include the possibility of carrying out the procedure for several menstrual cycles in a row. However, note that a single puncture of stimulated ovaries will do less harm than multiple.
Another advantage of IVF in natural cycle is that comapered to other programs its cost is usually lower than in programs where superovulation stimulation is performed.

Also, unlike in other programs, no special preparation for IVF in the natural cycle is not required.

The package includes (depending on the Doctor’s prescription)

• Prescribing natural cycle treatment plan;
• Consultation with Infertility doctor (up to 3 times);
• Follicle ultrasound (up to 3 times);
• Hormone level tests for monitoring ovarian stimulation (LH, estradiol, progesterone express-tests – up to 3 times)
• One of the following medications:
• Diphereline (0.1)
• Chorionic gonadotropin (up to 10.000)
• Ovarian puncture in natural cycle
• Staying in a hospital ward for 3 hours for monitoring purposes
• Embryological stage:
• Oocyte identification and assessment; 
• 2 sperm specimen preparation for fertilization;
• In vitro fertilization: ICSI;
• Embryo culture;
• Oocyte spindle apparatus assessment.

The package does not include

• Medications that are not listed in the program description;
• Medical assistance in case of emergency conditions;
• IMSI;
• Assisted hatching;
• Embryo biopsy;
• All kinds of preimplantation genetic diagnosis;
• Embryo storage;
• All consultations with related specialists;
• The use of donor material and its defrosting.

IVM procedure

IVM means in vitro egg maturation (in vitro) followed by IVF. The specialists of AltraVita clinic have sufficient capabilities and knowledge to conduct this process with high efficiency, as evidenced by reviews of IVF in natural cycle.Th

e combination of IVM and IVF methods makes it possible to simultaneously obtain a mature egg from a dominant follicle and a number of immature eggs from small (antral) follicles. Egg maturation takes place “in vitro”, and a mature egg undergoes fertilization in the standard way. High-quality embryos obtained by both methods are transferred into the uterus.

Indications for IVF in the natural cycle in conjunction with IVM

• Polycystic Ovary Syndrome
• Significant risk of ovarian hyperstimulation syndrome
• A history of benign hormone-dependent tumors
• Contraindications to the induction of superovulation
• Factors Affecting IVM Choice
• The ability to avoid the risk of developing ovarian hyperstimulation syndrome
• Lack of hormonal stimulation
• Affordable cost of the procedure, which is caused by a small amount of hormonal drugs used

Many couples choose to tray frozen embryo transfer program after a successful IVF attempt to have a second baby. 

The end result of this technique depends on various factors which include:

• The quality of the frozen embryo
• The endometrial thickness and if it is ready for the embryo transfer
• The hormonal therapy strategy.

Some scientists claim that the high dosage of hormones that women are injected with during the stimulation can alter the qualities of their endometrium and may have negative effect on its ability to accept and nourish the embryo. 

If the patients use the frozen embryo transfer program, there is no need to do take hormones in such high doses, which makes this program closer to the natural way of things. Consequently, the pregnancy is likely to go more smoothly from the physiological point of view. 

Is it necessary for the father to do a medical check-up with this protocol? Yes, it is. Even though he is not actually involved in the process of the transfer and has done the required tests during the first cycle, the frozen embryo transfer recommendations list does contain several obligatory examinations. As for the mother, out of all the usual hormone level exams she only has to do the progesterone blood test, because this hormone is prescribed to ensure a healthy pregnancy. 

Sometimes, though fairly rarely, the usual superovulation stimulation protocol is still required to prepare the endometrium for the transfer. This happens when there is no natural ovulation and if the standard preparatory procedures yielded no results. 
Regardless of their education level, many people still consider embryo cryopreservation a dangerous procedure that has the potential to harm their future baby. Sometimes, it may be hard for the parents to understand this process. These couples would rather dispose of their spare embryos, which is completely unnecessary and unfounded, just because they are afraid to freeze it. 

However, it is essential to realize the difference between a common freezing and cryopreservation. When you freeze something the usual way, the water in the issues crystalizes under the influence of low temperatures and destroys the cell membranes. Cryopreservation in liquid nitrogen happens at the ultra-low temperature of -196 С°. Under these conditions, the ice simply does not have enough time to form. After they are defrosted, more than a half of all embryos can be successfully implanted into the womb tissue and start developing there. Out of 100 frozen embryos, only 5 or 6 of them are lost. Studies have proved that in those cases the cause of death is not related to cryopreservation, but is normally of genetic origin. Large-scale case studies have also demonstrated, that children born from frozen embryos are not any different from other children in terms of general health and course of development, and the pregnancy is usually less problematic. It might be connected to lower amount emotional stress for the parents. 

Frozen embryos can be preserved for a very long time. An additional prove to that is the birth of a girl named Emma in 2017. Her embryo has been cryopreserved for 25 years, since 1992. The only condition is to strictly abide by the rules of cryopreservation and defrosting procedures. 

In Altravita we use various ART techniques. Thanks to high-level equipment and the skills of our doctors, we keep our statistic results up to the highest standards. You can get more information about cryopreservation from our gynecologists. Call the clinic using the phone number on our website and make an appointment.

Call the clinic using the phone number on our website and make an appointment.

Included services

• Scheme of patient’s endometrium preparation for embryo transfer
• Consultations of reproductive endocrinologist
• Ultrasonic monitor of endometrium for embryo transfer
• 6 frozen donor eggs
• Thawing of oocytes
• Identification and evaluation of oocytes’ maturity
• Preparation of sperm for fertilization using two samples of ejaculate
• ICSI/IMSI
• Cultivation of embryos until 5-6 day of development
• Freezing of embryos
• Fresh embryo transfer to the patient

Excluded services

• Additional medication
• Additional donor eggs, starting from 7^th
• IMSI – if indicated
• Assisted hatching
• Embryo biopsy
• Any type of PGD/PGS
• Frozen embryo transfer 

Included services

• Ovarian stimulation
• Medication for stimulation of ovulation:  gonadotropins (Puregon, Gonal, Menopour) 600 IU
• Folliculometry
• Hormonal monitoring of stimulation
• Consultations of reproductive endocrinologist
• One procedure of intravenous infusion of medication for OHSS (if required)
• Transvaginal ovarian puncture
• General anesthesia
• 2-3 hours stay in day hospital with medical monitoring
• Identification and evaluation of oocytes’ maturity
• Preparation of sperm for fertilization using two samples of ejaculate
• Cultivation of embryos until 5-6 day of development
• Freezing of embryos
• Embryo transfer

Excluded services

• Additional medicaments
• Emergency care in case of complications 
• Assisted hatching
• Biopsy of embryo
• Any type of PGD/PGS
• ICSI/IMSI fertilization
• Additional consultations of specialists
• Storage of frozen embryos
• Usage and thawing of donor gametes
• Frozen embryo transfer 

Included services

• Screening, stimulation of ovulation, compensation for anonymous egg donor
• Scheme of patient’s endometrium preparation for embryo transfer
• Ovarian puncture with general anesthesia for the egg donor
• Consultations of reproductive endocrinologist for the patient and the donor
• Ultrasonic monitor of endometrium for embryo transfer
• Preparation of sperm for fertilization using two samples of ejaculate
• ICSI/IMSI
• Cultivation of embryos until 5-6 day of development
• Freezing of embryos
• Fresh embryo transfer to the patient
   

Excluded services

• Additional medication
• IMSI – if indicated
• Assisted hatching
• Embryo biopsy
• Any type of PGD/PGS
• Frozen embryo transfer
• Storage of frozen material
• Additional consultations of specialists 

Included services

• Ovarian stimulation
• Medication for stimulation of ovulation:  Clostilbegyt 50 mg – 1 box, gonadotropins (Puregon, Gonal, Menopour) 600 IU, Diphereline 0.1 – 2 ampules, Cetrotide – 1 ampule.
• Folliculometry
• Hormonal monitoring of stimulation
• Consultations of reproductive endocrinologist
• Transvaginal ovarian puncture
• General anesthesia
• 2-3 hours stay in day hospital with medical monitoring
• Identification and evaluation of oocytes’ maturity
• Preparation of sperm for fertilization using two samples of ejaculate
• Cultivation of embryos until 5-6 day of development
• Freezing of embryos

Excluded services

• Additional medicaments
• Emergency care in case of complications 
• Assisted hatching
• Biopsy of embryo
• Any type of PGD/PGS
• ICSI/IMSI fertilization
• Additional consultations of specialists
• Embryo transfer
• Storage of frozen embryos
• Usage and thawing of donor gametes