Natural IVF
Q&A:
With Dr. Janelle Luk
Whether you’re from Manhattan or Madrid, getting pregnant or staying pregnant is not the same experience for everyone.
Nearly one in eight women will have trouble getting pregnant and need the help of infertility treatments such as IUI, IVF, PGT-A, and donor egg. However, in just the last 10 years, infertility care has become more refined, more successful, and in many cases, more natural.
Natural IVF, a process where fewer medications and injections are used to stimulate the ovaries, has become more widely used by many US IVF centers alongside traditional IVF stimulation protocols. One of the early adopters of natural IVF has been Generation Next Fertility based here in Manhattan. We sat down recently with one of the founding partners Dr. Janelle Luk to talk about how both natural and minimal stimulation IVF have helped thousands of hopeful parents while making Generation Next Fertility a top 10 NYC fertility center.
In a nutshell, what is natural IVF?
Less is more with natural IVF. Fewer medications, fewer injections, and often less stress for many patients. In short, we listen to each patients’ ovaries and incorporate just a handful of different medications to compliment the recruitment of a single high-quality egg or oocyte – what the body does naturally every cycle, every month.
In a traditional IVF cycle, a patient will have 50 or more injections of nearly 4,000 IUs of gonadotropins alone over the course of their cycle. While we still use a traditional IVF protocol at GNF for many patients, it’s not for everyone. We’ve been routinely using natural IVF in more than 40% of our patients over the last 10-years and outcomes have been as good as many centers who only offer a traditional IVF pathway to pregnancy.
How is minimal stimulation different from natural IVF?
Mini-IVF is essentially the middle of the road protocol between natural IVF and traditional IVF. We’ll incorporate maybe half as much stimulation medication to spur the development of a few high-quality eggs for retrieval in a mini stim cycle.
You mentioned that natural IVF often lowers stress levels, can you explain?
30% or more of patients we see every year have a mild to significant phobia of needles and injections. They have clinical levels of anxiety to this process – a problem the field still needs to fully solve. But, in a natural IVF cycle patients have less than 10% of the injections that are associated with a traditional IVF stimulation cycle. Less injections, less stress.
How is the GNF protocol different from other fertility centers?
We have more experience in managing these kinds of cycles than many other IVF centers in New York City and across the US. With this experience we’ve been able to adjust and refine the natural cycle experience. We’ll incorporate aspects of traditional IVF protocols as needed, we often include a duo stim protocol, and look at different luteal support pathways as well.
What kind of patients should consider natural IVF for their cycle?
Again, not everyone is right for everything. We do our best to deliver care based on the patient and not just the protocol. We listen to the body and go from there.
Most of the patients we see who end up following a natural IVF protocol have been recently diagnosed with cancer, have diminished ovarian reserve, have failed traditional IVF 2-3 times, or are needle-phobic and need IVF but can’t endure the number of injections.
Why adopt natural IVF, doesn’t one size fit all when it comes to IVF?
Our reproductive systems are very different from one cycle to the next based on age clinical history, genetic history, and so on. To help as many patients as possible we have to offer the widest number of treatments like natural IVF or mini-IVF.
My time in Hong Kong has given me a strong appreciation for different perspectives on philosophies on the body. I have been able to integrate both a view of medicine from the traditional perspective with my training in modern medicine and stimulation to reach a individualized level of care for each patient.
My clinical training was a Yale which was fantastic. But I knew that when I went into practice, I wanted to take the best from a successful system and find ways to help patients who fall outside the system. Often within a system, people fall through the cracks. Natural IVF can help those who often fall outside a traditional fertility experience.
Do you have any thoughts for patients as 2022 unfolds?
Yes, if you’ve been unable to find success within a traditional setting, consider well-established protocols like natural IVF. We’re here to listen and help. Don’t wait to get a second opinion and have hope. There’s an old proverb that says, “all things are difficult before they are easy.” We wish the best for all of our hopeful parents for 2022 and beyond!
