Comparison of the IVF-treatments

Traditional IVF

Relatively high-dose gonadotrophins are used (e.g. 150-300IE/day) to allow polyfollicular growth, thereby increasing the number of oocytes collected and therefore the success rate. GnRH-analogues are used to prevent a premature LH-surge. Fixed stimulation protocols are used which make IVF stimulation easier to perform. The disadvantages of these treatments are the higher psychological strain, treatment with 1-2 injections per day, risk of overstimulation and the risk of a multiple pregnancy.

Minimal Stimulation IVF

In minimal stimulation IVF, very low doses of gonadotrophins are used (e.g. 75IE/day) and are combined with GnRH-antagonists after a particular follicle size is reached to inhibit a premature LH-surge. This results in a few follicles. With this treatment, the above-mentioned risks of traditional IVF are less pronounced.

IVF-Naturelle® (Gonadotrophin-free IVF)

In pure natural-cycle IVF (NC-IVF), as a variant of gonadotrophin-free IVF, the LH-concentration is closely monitored and follicular puncture performed about 36 hours after the LH-surge. Pure NC-IVF is only used in isolated cases, as the LH-concentration must be closely monitored to determine the right time for follicular puncture. The IVF-Naturelle® centres only use this technique when the LH-surge has already been measured at a check-up so that the time of ovulation can be calculated.

In NC-IVF, follicle size during the cycle is measured using ultrasound and hormone levels are measured to induce ovulation when there is a follicle of ca. >18mm and estrogen levels are sufficient.

To increase the effectiveness of these techniques, individualized non-steroidal anti-inflammatory drugs (e.g., ibuprofen), one-off doses of GnRH antagonists (Cetrotide © and Orgalutran ©), and minimal doses of clomiphene citrate are administered just before ovulation. Since the term Natural Cycle IVF should no longer be used to after these modifications, we call these IVF treatments “IVF-Naturelle®”.

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