Can All Fertility Patients be Treated With All Types of IVF?

In a recent video, which you can watch here, Dr Antonio Rodrigues from Medfem Fertility Clinic answered a question that is often asked by fertility patients: can all fertility patients be treated by all the types of IVF?

In this article, we find out what are the different types of in vitro fertilisation or IVF treatments, whether these are suitable for all IVF patients and which type of IVF is the best option for you.

During an IVF cycle, there are a number of options regarding the type of medication or dose of medication that will be used, and how the treatment is performed.

The type of medication that is used is determined by using patient specific algorithms that factor in age, egg reserve or AMH levels, and the cause of infertility. The medication dosage is also determined through patient specific algorithms and can include normal dose, high dose, low dose, ultra-low dose and natural cycle IVF with no medication. Another variable in treatment options is conventional IVF versus IVF with ICSI.

Recent trends in fertility prefer ovulation induction that uses fewer medications and produces fewer but better-quality embryos than an ovulation induction that uses significantly higher doses of medications.

We briefly look at each type of IVF treatment below including natural cycle IVF treatment, modified natural cycle IVF treatment, low cost IVF treatment, low dose IVF treatment, mild IVF treatment, hyper stimulated IVF treatment, and IVF/ICSI treatment.

Natural cycle IVF treatment

Natural cycle IVF treatment involves egg collection aligned with your natural menstrual cycle – there is no ovarian stimulation involved. No stimulation means no oral and/or injectable medications are taken.

This type of IVF works in sync with your menstrual cycle to collect the egg naturally selected by your body. Your natural cycle is simply monitored, and an egg collection is performed when the natural ovulation occurs. The procedure is simple: patients see their fertility specialist a half hour before egg retrieval for a trigger injection to release eggs into fluid, like with other types of IVF.

This treatment typically yields only 1-2 naturally grown eggs and one embryo. It is used for patients with previously poor results with hyper stimulated IVF treatment or mild IVF treatment cycles, and is particularly suitable for women who are not responding to conventional IVF medications.

Modified natural cycle IVF

Modified natural cycle IVF involves taking medication for three to four days to block spontaneous ovulation, as well as low-dose hormones. This method takes less time than conventional IVF treatment.

Low cost IVF treatment

Low cost IVF treatment involves only oral medication. The objective is to retrieve two or three eggs, all of which are fertilised, so one or two embryos can be obtained. The embryos are only in lab for 2 to 3 days, not 5 days as with traditional IVF treatment. Due to the reduced cost of the medication and the reduced time in lab, this option is lower in cost and may be an option for some fertility patients.

Low dose IVF treatment

A relatively new and advanced reproductive technology (ART), low dose IVF treatment bridges the gap between traditional hyper stimulation IVF treatment (discussed below) and natural cycle IVF treatment.

Because it is a minimal stimulation IVF treatment, low dose IVF offers a gentle alternative, using oral ovulation induction agents and/or low doses of hormones to induce the growth of a small number of eggs. The process is identical to traditional IVF treatment, except that the goal is to create only a few but high-quality embryos for transfer.

This “gentle” ovarian stimulation yields 3 – 4 eggs and 2 – 3 embryos, increasing the cycle efficiency significantly. Whereas in traditional IVF treatment a high dose of gonadotropins is often used to maximise eggs/embryos from a single cycle, in low dose IVF treatment it is egg and embryo quality which is maximised rather than number.

Low dose IVF treatment is a useful method to help women achieve a pregnancy with minimal risks and low cost.

Mild IVF treatment

Mild IVF treatment requires the use of a mild dosage of stimulation. The objective is to get just a few good quality eggs to ensure one good quality embryo.

It is particularly suitable for patients who have a reduced ovarian reserve or low egg reserve but are still able to produce a relatively good number of eggs. It is also indicated where there is a low number of follicles, or if the ovaries are polycystic.

In these instances, through the use of less medication, mild IVF treatment enables a good number of eggs to be retrieved that are also of better quality.

Hyper stimulated IVF treatment

Hyper stimulated IVF is the norm or usual treatment where the patient has a normal egg reserve. It is often used if a patient has not conceived during a previous IVF treatment cycle due to poor quality embryos.

During hyper stimulated IVF treatment, the full dosage of medication is taken. A high dose of gonadotropins is often used to maximise the eggs and embryos from a single cycle. The objective of hyper stimulated IVF treatment is to collect between 10 and 20 eggs and to fertilise as many as possible.

Because many eggs are fertilised there should be several embryos, from which the strongest are chosen and the others frozen for possible future treatment cycles.


IVF with ICSI (Intracytoplasmic Sperm Injection) differs from traditional IVF treatment in the way the egg is fertilised. In standard IVF treatment, between 50,000 and 100,000 sperm are placed in the same dish as a single egg. The sperm is allowed to penetrate the egg of its own accord and to fertilise naturally.

In IVF with ICSI treatment, a single sperm is injected directly into the egg. This maximises the chance of fertilisation taking place as several steps in the early fertilisation process are bypassed and any potential problems the sperm may have in getting inside the egg is circumvented.

ICSI is done for severe male factor infertility, or if eggs have been frozen and thawed.

Which type of IVF treatment is right for you

So, how will you know which type of IVF treatment is right for you? The answer is simple: a consultation with a fertility specialist.

You can meet some of South Africa’s leading fertility specialists at Medfem Fertility Clinic in Sandton, Johannesburg. For example, our Dr. Johan Van Schouwenburg performed the first IVF treatment in South Africa with Professor Kruger at Tygerberg Hospital in 1983.

Since then, we have assisted couples struggling with infertility to experience the joy of parenthood, helping to bring more than 18,000 babies into the world. We do this by implementing individualised IVF stimulation protocols, customised to each patient according many factors, such as infertility diagnosis, age, weight/height, prior cycle outcome and prior reproductive history.

Medfem Fertility Clinic’s team are committed and understanding team of medical professionals, who have the experience, knowledge and desire to provide you with the best chance of a successful outcome at the end of your treatment. If you would like to meet with us, simply click here to book an initial consultation or contact us telephonically on +27 (11) 463 2244.

We look forward to meeting you!

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