Fertility Options before IVF

Using Progesterone in the luteal Phase

Using progesterone in the luteal phase can be beneficial for couples trying to conceive naturally after experiencing first-trimester losses. Progesterone plays a key role in preparing the uterine lining for implantation and supporting early pregnancy. Low levels have been linked to implantation failure and early miscarriage.

Supplementing progesterone after ovulation may help stabilise the endometrium and reduce the risk of loss in women with suspected luteal phase deficiency. Studies suggest it can improve pregnancy outcomes, particularly in those with a history of recurrent miscarriage. It’s a low-risk, supportive option that may enhance the body’s ability to sustain a healthy pregnancy.

Non medicated Monitored Cycle

A non-medicated monitored cycle is a natural fertility cycle closely observed using ultrasound and hormone blood tests to assess ovulation and cycle patterns without the use of fertility drugs. It’s often recommended for those struggling to conceive or experiencing miscarriage to better understand cycle health, ovulation timing, and luteal phase function.

Transvaginal ultrasounds monitor follicle growth, endometrial thickness, and ovulation, while hormone tests track oestradiol, LH, and progesterone levels. If ovulation is delayed or uncertain, a trigger shot (usually hCG) may be given to prompt the final maturation and release of the egg, mimicking the body’s natural LH surge. This can help optimise timing for conception, whether natural or via IUI and ensure the egg matures properly for fertilisation.

Tracking cycles can uncover issues like poor follicle development, thin lining, or luteal phase defects, helping guide future fertility plans and increase the chances of a successful pregnancy without overmedicating..

Medicated Monitored Cycle

A medicated, monitored tracking cycle is a option often used for those struggling to conceive or experiencing recurrent miscarriage. It involves using fertility medications, such as letrozole or clomid, to stimulate the ovaries and support the development of one or more follicles.

Throughout the cycle, transvaginal ultrasounds and blood tests are used to track follicle growth, endometrial lining thickness, and hormone levels to time ovulation precisely. When a mature follicle is identified, a trigger shot of hCG (human chorionic gonadotropin) may be given to induce ovulation. This helps ensure that the egg is released at the optimal time for fertilisation, whether naturally or through timed intercourse or intrauterine insemination (IUI). The trigger also supports the final maturation of the egg, increasing the likelihood of successful conception.

Tracking cycles can uncover issues like poor follicle development, thin lining, or luteal phase defects, helping guide future fertility plans and increase the chances of a successful pregnancy with IVF.

IVF For Recurrent Miscarriage and Fertility Preservation

IVF can helpful for preserving future fertility in couples who conceive naturally but have suffered  recurrent miscarriage. By retrieving and freezing embryos now, when egg quality may be more optimal, it offers a safeguard for future family-building, especially if age or reproductive health decline over time. IVF also allows for advanced embryo testing, such as PGT-A (See below) to help select chromosomally normal embryos, potentially reducing miscarriage risk. For those navigating loss, IVF provides control and can preserve your future family, making it a good option for emotional reassurance and long-term planning.

PGT-A testing

PGT-A (Preimplantation Genetic Testing for Aneuploidy) is an advanced technique used during IVF to screen embryos for chromosomal abnormalities before transfer. It helps identify embryos with the correct number of chromosomes, increasing the likelihood of implantation and reducing the risk of miscarriage.

For women over 35 or those with recurrent miscarriage, failed IVF cycles, or unexplained infertility, PGT-A can be especially valuable. By selecting chromosomally normal embryos, it may reduce the number of IVF cycles needed, shorten the time to a successful pregnancy, and improve overall IVF success rates.

A 2019 study in Fertility and Sterility showed that PGT-A increased live birth rates per transfer and reduced miscarriage rates. While it doesn’t improve embryo quality, it helps select the best embryo for transfer reducing time frames to a healthy pregnancy. A further study by Yale university showed that aneuploid embryos had a 0% live birth rate.

If you are suffering with recurrent miscarriage and considering IVF then you should really consider PGT-A testing as part of that cycle, as IVF on its own does not reduce miscarriage risks.

Rachel Sherriff is a fertility acupuncturist with a clinic ‘The Fertility Suite in Surrey’ She supports couples who are struggling to conceive using acupuncture, reflexology, nutrition and online courses. She can help you achieve a happy, healthy pregnancy whether naturally or through fertility treatment. Having been through fertility struggles and treatment herself she wants you to feel empowered, educated and confident to take back control of your fertility.

www.thefertilitysuite.co.uk