Which type of IVF treatment is right for you?

Over the last 30 years, in vitro fertilisation or IVF has proven to be a safe and effective fertility treatment and has helped millions of couples around the world to become parents.

Over the decades, different types of IVF treatments have developed, as Dr Tony Rodrigues from Medfem Fertility Clinic explained at the recent Fertility Africa Show.

In this article we take a brief look at what IVF treatment is, discover the different types of IVF treatments and find out how to know which type of IVF treatment is right for you.

What is IVF?

IVF treatment was originally developed for women with damaged or missing fallopian tubes. The world’s first IVF baby, Louise Brown, was born in 1978 in the United Kingdom.

Since 1983, IVF has been the standard treatment for infertility and more than 5 million babies have been born worldwide as a result of IVF treatment. In fact, IVF treatment success rates are now comparable – and even superior – to those of nature.

What does IVF treatment involve?

IVF treatment is a process of assisted reproduction in which the egg and sperm are fertilised outside of the body to form an embryo, which is then transferred to the uterus to hopefully implant and become a pregnancy.

However, IVF treatment is not a single event, but rather a series of procedures that are completed over five stages in a treatment cycle.

The Five Basic Stages in the IVF Procedure

Stage 1: Ovarian Stimulation and Monitoring
Stage 2: Egg Retrieval
Stage 3: Fertilisation and Embryo Development
Stage 4: Embryo Transfer
Stage 5: Luteal Phase Support

IVF treatments usually commence with a course of hormone therapy to stimulate the development of several follicles in the ovary. Under ultrasound guidance, these follicles are then punctured with a specialised needle to retrieve the eggs in the follicles. The eggs are then fertilised in a petri dish (‘in vitro’ which literally means ‘in glass’) to create several embryos (fertilised eggs). After three to five days in an incubator, one or two of these embryos are transferred through the vagina to the uterus, where implantation hopefully occurs and pregnancy begins. The whole process from commencement of ovarian stimulation up to the embryo transfer stage usually takes around three weeks.

As in natural conception, not every embryo implants to become a pregnancy. For this reason, the surplus embryos are frozen for subsequent IVF treatments, if the first treatment cycle fails.

Different types of IVF

There are also different types of IVF treatments, as Dr Rodrigues explained during his presentation “Natural Cycles and Mild IVF” at the recent Fertility Show Africa. (You can watch the video here…)

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

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.

Mild IVF treatment

Mild IVF treatment requires the use of a mild dosage of stimulation, or in simpler terms, less medication. 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.

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 and natural cycle IVF treatment (discussed below).

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.

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.

The process is identical to traditional IVF treatment, except that the goal is to create only a few but high-quality embryos for transfer.

Low dose IVF treatment also answers two major concerns for both patient and doctor — cost and overmedication. Recent trends in the fertility field prefer an ovulation induction that uses fewer medications and produces fewer but better-quality embryos than an ovulation induction that uses significantly higher doses of medications. In other words, low dose IVF is a useful method that can be used to help women get pregnant with minimal risks and low cost.

Low cost IVF treatment

In low cost IVF treatment, only oral medication is taken and the objective is to retrieve 2-3 eggs, all of which are fertilised, so one or two embryos can be obtained. In addition, the embryos are only in lab for 2 to 3 days, not 5 days as with traditional IVF treatment. Given 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. It is recommended that this option is accompanied by counselling and that patients understand that if not successful, the process will have to be started from scratch again.

Natural cycle IVF treatment

Natural cycle IVF treatment 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 have proven not to be responding to the conventional medications used in IVF.

Natural cycle IVF treatment involves egg collection aligned with your natural menstrual cycle – there is no ovarian stimulation involved. Your natural cycle is simply monitored, and an egg collection is performed when the natural ovulation occurs. It works in sync with your menstrual cycle to collect the egg naturally selected by your body.

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.

No stimulation means no oral and/or injectable medications are taken. This treatment typically yields only 1-2 naturally grown eggs and one embryo.

Modified natural cycle IVF

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

Which type of IVF treatment is right for you

The next question is how to determine which type of IVF treatment is right for you? The answer is simple: an initial consultation with a fertility specialist.

At Medfem Fertility Clinic in Sandton, Johannesburg you can meet some of South Africa’s leading fertility specialists. The team at Medfem Fertility Clinic are very proud that our Dr. Johan Van Schouwenburg performed the first IVF treatment in South Africa with Professor Kruger at Tygerberg Hospital in 1983.

Over the last 30 years, our team has helped bring more than 30,000 babies into the world at our accredited clinic that offers advanced facilities; technologies on par with the latest medical advancements and a range of fertility treatments to achieve great success rates.

Our fertility specialists at Medfem Fertility Clinic implement individualised IVF stimulation protocols, which are customised to each patient according to a multitude of factors, such as infertility diagnosis, age, weight/height, prior cycle outcome and prior reproductive history.

Setting up your initial fertility consultation to determine what type of IVF treatment is right for you is as simple as clicking here or contacting us on +27 (11) 463 2244.

We look forward to meeting you at Medfem Fertility Clinic!


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