Natural FET versus what?

[Anonymous]

What does it mean when people say they're having a natural FET? i understand it must mean no drugs but what drugs would you be on (progesterone?) in a "not natural" FET cycle? What are the pros/cons/reasons for one versus the other?

[Anonymous]

Natural for me meant nothing but an HCG trigger shot. Some docs/clinics prefer to do some stim meds and really resist an unmedicated FET. For me, I didn't want to take additional meds and my clinic had equal success rates for medicated and unmedicated FETs. Ask your clinic for their stats on this.

[Anonymous]

the only thing my RE had me do in my last natural FET was prometrium, it didn't work, but i plan on doing it again next month. it's just less stress on your body.

[Anonymous]

thanks -- why would they have you do the stims too -- just to drop more eggs and up the odds?

[Anonymous]

Here is what the IVF connections website says:

During a natural cycle FET, your natural cycle is monitored to determine the correct timing to transfer the embryos. During a medicated FET you are given medications (Sometimes Lupron, usually some form of Estrogen and then after transfer some form of Progesterone) to create an artificial cycle in which the clinic has more control over when to transfer the embryos.

[Anonymous]

Anonymous wrote:thanks -- why would they have you do the stims too -- just to drop more eggs and up the odds?

20:39 here. Yes, I think so. As another PP said, some clinics and doctors also want to control the timing of the cycle and use meds for that. I forgot that I also used Prometrium suppositories post-FET, so I guess that counts as medication.

[Anonymous]

20:39 is incorrect---you don't take stims (gonal F, menopur bravelle) at all during any type of FET. There's no such thing as "dropping more eggs" when you are transferring back frozen embryos.
In a natural FET you simply put the frozens back at the time in the cycle when ovulation would normally occur. No additional drugs except for maybe some progesterone support (suppositories) in the two week wait.

In a medicated FET the entire cycle is controlled by using some combo of bcps/lupron/estrogen/progesterone. Then the embryos are put back at the artificially determined point in the cycle in which the hormone levels are optimum and the uterine lining is ideal for implantation.

For whatever reason(s), (not sure) medicated FETs generally have a higher chance of working and many practices use them exclusively (SG being one of them). It likely comes down to scheduling convenience---I imagine it would be difficult for SG be monitoring a zillion womens' natural cycles so they could bring them all in at the exact right moment to put embryos back. Much easier for them to control everyone with medication.

[Anonymous]

Anonymous wrote:20:39 is incorrect---you don't take stims (gonal F, menopur bravelle) at all during any type of FET. There's no such thing as "dropping more eggs" when you are transferring back frozen embryos.
In a natural FET you simply put the frozens back at the time in the cycle when ovulation would normally occur. No additional drugs except for maybe some progesterone support (suppositories) in the two week wait.

In a medicated FET the entire cycle is controlled by using some combo of bcps/lupron/estrogen/progesterone. Then the embryos are put back at the artificially determined point in the cycle in which the hormone levels are optimum and the uterine lining is ideal for implantation.

For whatever reason(s), (not sure) medicated FETs generally have a higher chance of working and many practices use them exclusively (SG being one of them). It likely comes down to scheduling convenience---I imagine it would be difficult for SG be monitoring a zillion womens' natural cycles so they could bring them all in at the exact right moment to put embryos back. Much easier for them to control everyone with medication.

20:39 here. Sorry, but in the case of our clinic I'm not incorrect. In some cases they do use additional stim meds, plus lupron/OPs etc. The clinic does three types of FET: unmedicated (which actually includes prometrium suppositories post-FET), medicated (lupron etc. for women with certain profiles), and fully medicated (lupron etc. plus stims), again for women with certain profiles. The latter case is rare, but does happen at our clinic. I don't know the reasoning behind it, as we weren't interested in doing it and our doctor didn't recommend it. The clinic provides full data on all three types of FET cycles so you can compare success rates. The clinic does NOT, however, use medicated FET cycles to get everyone on the same cycle. Period. Now this is a very large practice in California, and I'm sure things are different here. But to me it's a red flag if a clinic insists on medicated FET cycles.

[Anonymous]

20:39---

what clinic in California is this that does FET with stims? I've never heard of this and I'm fascinated. I'd love to see their success rates.
I guess they go ahead and do a retrieval and then put back fresh embryos and frozen embryos? So really it's a fresh cycle with added frozens? That seems like a lot of embryos and I wonder why they don't just put back all fresh or all frozen. Seems like having embryos created at different time points would just confuse things and make if difficult to predict pregnancy rates and/or control for multiples.

I'm really interested in understanding this!

[Anonymous]

I'm intrigued too. Perhaps it's for those using donor embies or donor eggs, so they wouldn't know for sure? I feel like maybe I've heard of this possibility.

[Anonymous]

since we're talking about clinics, specifically, anyone know what's most common at Columbia Fertility Ass?

[Anonymous]

I got the feeling that CFA does medicated and naturally equally. Depends on the woman, they cycles, and their flexibility. There are other posts on this site about FET to read. Search a few pages back.