Mini/Natural IVF

[Anonymous]

Has anyone tried the mini-IVF program with Dr. Muasher or the natural cycle IVF with Dominion? I'm thinking of switching clinics and would be interested in experiences. (Please give your dx/age, too - my issue is likely age).

Thanks!

[Anonymous]

I originally had wanted to do natural cycle IVF with Dr D at Dominion (at the time I had just turned 32 and was dx with unexplained IF). Dr D said we were good candidates for nat cycle but I really did not like Dr D (you can see the thread on Dr D to get an idea of why that is). I ended up getting a second opinion and that RE said that the problem with natural cycle is that its hard to time it right so many cycles end up being converted to IUI, but you are still charged for all the monitoring. Since the monitoring (not the drugs) is where REs make all their money, the new RE said that natural cycle is a big money maker for RE's but not such a great deal for patients. That said, the new RE does not do many natural cycles and he obviously had a monetary interest in getting us to switch practices, so I took what he said with a grain of salt. At the same time, the new REs logic did make sense to me (added with the fact that I hated Dr D) so I switched. But I'd still recommend at least meeting with Dr D (or maybe Dr Gordon) to discuss it and see what you think. There is some real appeal in avoiding the shots!!! As for mini-IVF, my new RE said that since the only fertility drug that has shown any increased risk of cancer is clomid, why would you use clomid in IVF instead of injectibles if you are worried about cancer risk (cancer risk was a big concern of mine going into IVF). Sorry to be so negative, maybe others who actually stuck with natural cycle had better experiences. And BTW, the risk of cancer associated with Clomid is small, I think, and is only an issue with prolonged use. Good luck!!!!

[Anonymous]

OP here. Thanks for the response. Can you explain more about the issue of timing the cycles? My understanding is that Dominion uses a trigger shot, so they would know when to retrieve. My body has always been "on schedule" doing IUIs, so I'm not worried about ovulating early . . . .

The reason I'm looking at mini-IVF is that I'm a poor responder to the regular IVF protocols, but a good (not great) responder to IUI protocols.

[Anonymous]

PP here, I think that if you are a poor responder then what I said isn't relevant (or at least the advice you would get might be very different since I was just starting out, and REs seemed to assume that I would respond well). I don't really have any details about the timing of the cycles. I assume that Dominion tries to monitor you pretty closely - I think my new RE was just saying that they have less control than they do when they are using drugs (assuming you respond well to the drugs). One thing I forgot to mention is that Dr D told me that if I was going to do nat cycle that I would have to do ICSI. There is also a clinic in NYC (maybe called new hope?) that does mini-IVF. There was a Wall Street Journal article about it that you could try to google. I hope this helps!!!

[Anonymous]

new poster here.

I also consulted with Dominion (Dr. D) because I was interested in their natural cycle program--- as a way of avoiding taking stims (which I've had a hard time with) and avoiding multiples (I have twins from previous IVF cycle).
I'm 34 and have a diagnosis of either unexplained infertility or mild male factor (we've never been quite sure).

I think the issue with spontaneous ovulation (despite triggering) on natural cycle is that you don't take any lupron or other forms of supression like you do with other IVF so your body is free to release the egg early despite the trigger. With IVF, the lupron or antagonist drugs (if you're on an antagonist protocol) prevent ovulation until a trigger releases the eggs. With IUI and natural cycle you run the risk of the body ovulating naturally even in the time between the trigger and insemination/retrieval. If you have a history of successfully timed IUIs then I imagine this would be less of a problem in the future because perhaps your cycles are easier to track than some.

Also, with natural cycle IVF you are only retrieving from one follicle and there is always a chance that that egg (or any egg) will be immature or post mature or somehow otherwise incompatible with fertilization. It's tricky to get the timing right.

We ended up not going with natural cycle mainly because like the previous poster we were totally turned off by Dr. D. I left the office thinking that he could guarantee me pregnancy and I wouldn't give him a dime. However, I have heard that his partner (Dr. Gordon) is much nicer and actually quite kind. I've heard good things about him. My husband was in favor of going back for a consult with him. However, I then talked with my doctor at Shady Grove (who i think walks on water and who I trust implicitly over 4 years of treatment) and I decided on another medical cycle.

Good luck!

[Anonymous]

Op here. Thanks. I actually think the mini-ivf would be better for me than natural because I would likely produce 3-4 follicles (and hopefully eggs) verses one with natural cycle, and the cost is not much more than the natural ivf. I'd like to stick with SG because of their lab, but I don't know if they're going to let me try another high stim IVF cycle. And I certainly don't want to pay their full-stim price if I only produce 3 follicles on a high dose protocol. My only concern is what I give up in terms of lab/embryologist quality by switching to Muasher's practice.

[Anonymous]

Anonymous, I'm curious to know- did you go with Muasher? I consulted with him already on mini-IVF (FSH=12.5). May try next month. How was your experience and the result? thanks

[Anonymous]

Just curious as to why you would do mini-IVF (assuming this is with clomid) and not traditional IVF. Mini-IVF was appealing to me at first too because I was afraid of the drugs, until an RE pointed out that mini-IVF involved taking the only IVF drug that has been associated with increased cancer rates (ie Clomid), whereas the IVF injection drugs are safer. Just something to consider...

[Anonymous]

09:43 - I'm generally pretty concerned about staying away from any potential carcinogens, but I have to wonder if taking Clomid for one or two cycles of IVF is going to have a huge impact. I'd suspect that it's still a relatively small dose, and we're not talking about long-term use here. Not trying to be argumentative... It just seems somewhat remote to me. Are the mini-stim doses much higher than what they give women for IUIs or the Clomid Challenge Test?

[Anonymous]

09:43 here. I think the clomid dose for mini-IVF is similar to what you'd get for an IUI (I have no idea about clomid challenge since I skipped that). The thing is that if you start with 3 clomid/IUI cycles and then do 3 clomid IVFs (which could easily happen given the success rates), you'd be at the 6 cycles where they start to *maybe* see increased cancer rates. Whereas with injectibles there is much less evidence of any long-term health risk. If you do traditional IVF you could always ask that your RE be conservative with your drug dosing to prevent some of the side effects of the drugs.

I'm just trying to give you another viewpoint from someone who was originally terrified of the idea of traditional IVF. It seemed very risky to me and the shots freaked me out. In the end, the parts of it that were the worst for me (and I did 4 cycles at 2 clinics) were the egg retrieval surgery and the two week wait after the IVF. And you still have to deal with both of those things with mini or natural IVF. I found talking about this with Dr Frankfurter at GW to be very helpful. He did not dismiss my fears, and instead talked through the issues very patiently with me. We ended up not using his clinic for our IVF cycles, but it was good to talk through our options with him (although he does not do min or natural IVF so he is clearly not unbiased). Good luck with whatever you decide!!!!!!