Ten years ago we introduced a radical concept to the Washington DC area…Natural Cycle IVF. Patients who had tried a traditional stimulated IVF recipe and had found it wanting could now try a markedly different approach. By allowing the follicle to grow on its own there was no risk of hyperstimulation and no problems with cycle cancellation for a poor response to medications either! Since 2007 we have helped many women succeed with this approach including a number who have had 2 and 3 children with us using NC IVF.
Since 2007 we have helped many women succeed with this approach including a number who have had 2 and 3 children with us using NC IVF.
Another seismic shift occurred a few years ago when we dropped HCG as a trigger shot for most IVF cycles and replaced it with GnRH-a (Lupron) trigger. Overnight we essentially eliminated ovarian hyperstimulation syndrome but also made the decision to go with a freeze-all approach and eliminate all fresh ET in stimulated IVF. We believed that the evidence strongly supported that the endometrial lining was not ideal in stimulated cycles and outcomes for babies and mothers were better in frozen embryo transfer cycles in which the hormone levels were more similar to natural cycle levels. Finally, as most patients were now electing to pursue Preimplantation Genetic Screening (PGS) on their embryos there was no reason not to pursue a freeze all strategy since PGS precluded a fresh ET while awaiting the results of the embryo biopsy.
… there was no reason not to pursue a freeze all strategy since PGS precluded a fresh ET while awaiting the results of the embryo biopsy.
Finally, we now have a tool to assess the precise timing of the embryo transfer in an FET cycle: the Endometrial Receptivity Assay (see my previous blog on this topic). All of these changes were clearly for the good. The old recipe and approach tossed out and the adoption of the new paradigm shown to improve outcomes ranging from the elimination of OHSS to the identification of the ideal embryo to pick for transfer.
…we now have a tool to assess the precise timing of the embryo transfer in an FET cycle
Change can be good. At Dominion we embraced these changes and our patients ended up benefiting in many ways.