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Implementing and Managing Natural and Modified Natural IVF Cycles

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Organization and Management of IVF Units

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Abstract

The first IVF cycle was achieved in a natural menstrual cycle. Thereafter the complexity of managing natural IVF cycles, the need to maximise success rates per cycle despite laboratory limitations and the advent of new drugs led to the development of the so-called “long protocol” and IVF practice drifted away from natural cycles. Whilst the “long protocol” remains the most commonly used IVF protocol worldwide, it has been associated with iatrogenic complications such as ovarian hyperstimulation syndrome, high treatment cost due to high drug doses required, and concerns regarding the impact of a non-physiological hormonal environment on gametes, embryos and the endometrium. On the other hand natural IVF cycles are not associated with ovarian hyperstimulation syndrome, can be performed without any drugs or with low dose drugs only and, based on recent evidence, they offer a more physiologic environment for gametes, embryos and implantation. At the same time advances in technology have significantly improved the efficiency of embryology laboratories, eliminating the need for large numbers of gametes and favouring quality over quantity.

Natural cycles are now reclaiming their role in IVF and advances in pharmacology and ultrasound facilitate the management of these cycles. They can be the treatment of choice in certain patient groups, such as women with very low ovarian reserve, women in whom drugs are contraindicated or there has been a history of significant ovarian hyperstimulation syndrome, and women who opt for a more natural approach to IVF treatment.

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Authors and Affiliations

  1. Create Fertility, 3-5 Pepys Road, West Wimbledon, London, SW20 8NJ, UK

    Mara Kotrotsou MUDr & Geeta Nargund FRCOG

  2. Create Fertility, 150 Cheapside, London, EC2V 6ET, UK

    Stuart Campbell DSc, FRCPEd, FRCOG

  3. 34 Corfton Road, London, W5 2HT, UK

    Stuart Campbell DSc, FRCPEd, FRCOG

Authors
  1. Mara Kotrotsou MUDr
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  2. Geeta Nargund FRCOG
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  3. Stuart Campbell DSc, FRCPEd, FRCOG
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Correspondence to Mara Kotrotsou MUDr .

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Editors and Affiliations

  1. School of Medicine, University of Sydney, Sydney, New South Wales, Australia

    Steven D. Fleming

  2. ASTRA Fertility Group, Mississauga, Ontario, Canada

    Alex C. Varghese

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Kotrotsou, M., Nargund, G., Campbell, S. (2016). Implementing and Managing Natural and Modified Natural IVF Cycles. In: Fleming, S., Varghese, A. (eds) Organization and Management of IVF Units. Springer, Cham. https://doi.org/10.1007/978-3-319-29373-8_15

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  • DOI: https://doi.org/10.1007/978-3-319-29373-8_15

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