Clomid/Gonadotropins with IUI Failed but Natural Cycle IVF Worked

This is the same old story for our practice time and time again. But it's a good story.

C.L. is a healthy 37 year old delightful lady, unable to conceive for the past 5 years of her marriage. She was evaluated at a local infertility clinic and her evaluation was completely normal. Thus, her diagnosis was unexplained infertility of a prolonged duration. Her doctor recommended 3 treatment cycles of clomid/gonadotropins with timed intrauterine inseminations(IUI). In all of her treatment cycles she responded very poorly to the fertility drugs, only producing 1or 2 eggs per cycle and no pregnancy occurred. She did not wish to again use fertility drugs for IVF and there really was no good reason to do so since she did not previously respond well to them. So, she came to us to inquire about Natural Cycle IVF (NC-IVF) in late June, 2009.

Using NC-IVF, we monitored her natural menstrual cycle and retrieved one egg which fertilized and a single 8 cell embryo was transferred but no pregnancy occurred. In her very next menstrual cycle, we again retrieved a single egg and transferred a single blastocyst embryo in October, but this time with a successful clinical pregnancy. So, this 37 year old lady with prolonged infertility and who poorly responded to fertility drugs was able to successfully conceive after 2 treatments of NC-IVF. She avoided using fertility drugs and her costs were much less than a single cycle of stimulated IVF.

We do not disagree with her previous decision to try fertility drugs and IUI. Unfortunately, however, those treatments did not work. However, we see many patients who have previously failed such treatments or who have failed to become pregnant using stimulated IVF, achieve success using NC-IVF. In our opinion, these two types of IVF, while similar in many respects, are radically different in terms of oocyte and embryo behavior and quality. We are not alone with this opinion and observation. In 2008, in the journal Fertility and Sterility, a study in over 500 cycles of NC-IVF in patients who were known "poor responders" to fertility drugs, showed NC-IVF to be an effective treatment. (See Schimberni et al, Fert/Steril, 2008).

Yes, it's the same old story but it's a very good one! Wishing everyone a warm, bright Holiday Season and New Year. Michael DiMattina, M.D.