# How does natural FET work?



## Belfield (Jun 18, 2008)

Hi guys!

Just wondered if anyone can tell me how a natural FET cycle works.  We have DE 3 frosties (all 4 cell) in Kiev and are hoping to go back for them early next year.  I had a very bad time on the medications (Pill, Progynova and Cyclogest - was on them for 3 months in total) and am not sure I can face the whole lot again... Problem is, my cycles are somewhat irregular (am 43, also fsh last year was 13.2) and with having to go to Kiev that makes it all the more complicated...  Fortunately I never have a problem building up a good womb lining but sometimes I don't ovulate and my progesterone levels in second half of cycle can be low (although I'd be happy to support this part of cycle post ET with Progesterone)...

Is it essential to ovulate or is it OK to go ahead at some point in the second half of the cycle provided you have a good womb lining and can support it with Progesterone?  I'm happy to take the Progesterone but the other drugs made me feel awful (bled for 30 days on the Pill, red cell count and haemoglobin levels very low, got hypoglycaemia symptoms etc.).

Good luck to everyone on a cycle and apologies for my ignorance...


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## ☼♥ Minxy ♥☼ © (Jan 13, 2005)

Hi

Different clinics have varying protocols when it comes to natural FET so you'd need to check directly with yours.

As far as I'm aware, to do natural FET you need to have fairly regular cycles and ovulate naturally otherwise it would be difficult to time the transfer.

Some clinics get you to use OPKs to check the LH surge and then time transfer of embie(s) from then, our clinic doesn't do this as they say OPKs aren't reliable enough so they do scans instead.

I've had 2 "natural" FETs a couple of years ago.

With our first FET, I had scan on cd2 (not so pleasant !) to ensure no cysts and womb lining shedding properly.  I then had another scan on cd9 (4 follies, despite not being on any drugs - 2 on right at 9mm and 2 on left at 10 & 11mm, womb lining 8mm)...more scans on cd11 & cd14 (I ovulate naturally cd14/15)...the dominant follie was 18mm and womb lining 9.7mm.  

Although it was an unmedicated/natural cycle, I still had to use Ovitrelle trigger jab (like Pregnyl) to exactly time ovulation so consultant could calculate ET...I had the Ovitrelle jab at 2am on cd15 so ovulation should happen about 36hrs later (approx 2pm on cd16).  I then had ET on cd18 at approx 2pm - both embies were 2 days old so timing was pretty exact.  I was also prescribed cyclogest for the 2ww even though I have naturally high progesterone levels.  I'm also prescribed clexane, prednisolone and aspirin for blood clotting and immune issues (diagnosed after 2 naturally conceived early mcs's).  This FET resulted in chemical pregnancy (early mc).

With the 2nd FET I had scan on cd3 (our consultant likes to have them as close to cd1 as possible) and then another on cd12 where womb lining was 7.1mm and dominant follie at 17mm...then another on cd14 which showed I'd ovulated that morning (so no trigger injection needed) but for some reason my womb lining was a little thin at 7.9mm (never had problem before) so I was prescribed oestrogen tabs to thicken it up a bit.  Had scan cd17 and womb lining was up to 8mm so I had ET on cd18.  Only one embie of remaining 2 survived the thaw so we had SET (single embie transfer) of 2 day old embie so timing not as exact as with first IVF as I ovulated cd14 but had transfer 4 days later...consultant did say that it would be fine within a few days.
As well as my own natural progesterone I was prescribed  crinone 8%, cyclogest and ovitrelle (HCG injections) at 3dpt and 8dpt as support during 2ww.........plus the prednisolone, clexane & aspirin !  Yet another chemical pregnancy 

Admittedly, although mine were "natural" FETs I did still have quite a bit of medication...mainly "non standard" treatment drugs to try to prevent me miscarrying but also did have the progesterone (and the oestrogen with 2nd), so obviously not a "straight forward" natural FET ! 

Both FETs used 2 day old embies from our 1st IVF (4 frostie and 3 survived).  We've got 6 frosties from our 2nd IVF frozen day 3 and we've been advised to thaw all and try to take to blastocyst for a day 5 FET........but this may mean I need to have medicated FET as they'll need to have more control over my cycle if they're to time my transfer along with thaw embies and culture from day 3 to day 5.  Not sure when we're doing this yet....maybe later this year.  .....but reason I mention this is because it shows they need to have a degree of control over certain aspects of FET, just as they have complete control over our cycles with IVF, but with natural FET they usually need you to have regular cycles and ovulation.

To be honest, I really don't know how it would work as with FET I believe you have to ovulate prior to having the transfer....it's the oestrogen produced by the developing follicle that encourages the womb lining to thicken up......and if you don't have this follicle (ie don't ovulate) then you'd need to have oestrogen to help thicken the womb lining.  Without having regular cycles with ovulation it would be very hard for the clinic to judge when to put the embryo back so they'd need to control your cycle which would mean medicated FET.

However, I'm obviously not medically qualified so I really think this is something you need to discuss in full with your consultant and get their professional opinion and advise.

Sorry if not been much help 

Good luck
Natasha


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## Belfield (Jun 18, 2008)

Hi Natasha,

Thanks so much for taking the time and trouble to respond.  Your post is really detailed and very helpful and I was very interested to read of your experiences (but so sorry to read of the BFNs and the rest of your story   ).  IF is such a rough road, with so many pitfalls yet enough glimmers of hope to keep us going  ...  I so hope your FET later this year will be successful.

I'm going to speak to my consultant re 'natural' FET, although like you I may end up needing to support with other medicines.  I basically just want to avoid the long down-reg if I can (I had 2 months on the Pill and bled for most of it!).  I think even if I have several 'false attempts' i.e. don't ovulate when expected etc. the stress of going through this will be far less than what I went through on the last medicated cycle - at least physically I will feel fit (hopefully!) which makes the mental stress of abandoned cycles etc. easier to cope with....

My last own cycle IVF was 2004 and I think I must have been feeling much fitter and stronger then - I guess age doesn't help (I'm 43) but also the protocol was much shorter...  I'm in the position now where I've frosties to use up but can't face going through the same protocol again (meanwhile my consultant is not keen to change anything about the protocl   ).  Sorry am starting to ramble now - better sign off!

Wishing you all the best with your FET and thanks again for your help.  It's given me a lot to think about and now I've more idea of what questions to ask.  Thank-you!


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