Natural Is Not Better: First Prospective "Natural" IVF Trial Reports No Benefit, May Require More Time and Cost vs. Traditional IVF

BASKING RIDGE, N.J., Oct. 18, 2016 /PRNewswire/ -- Reproductive Medicine Associates of New Jersey (RMANJ), a world-renowned leader in the field of infertility treatment and research, presented new data today regarding one of the more recent controversies of contemporary in vitro fertilization (IVF) at the American Society for Reproductive Medicine (ASRM) 2016 Scientific Congress & Expo this week in Salt Lake City, Utah.

The prospective research study, titled "Natural Is Not Better: Gonadotropin Stimulation Does Not Increase Aneuploidy or Diminish Implantation Rates of Euploid Embryos," marks the first time results from so-called "natural IVF" have been compared to those from traditional IVF treatment. The study was conducted between 2013 and 2015 and included more than 2,000 patients.

Touted by many as a "patient-friendly" alternative to traditional IVF procedures, RMANJ's researchers found that "natural" IVF does not result in higher quality embryos or higher pregnancy rates, and also showed that overall success rates were much lower versus patients undergoing traditional IVF.

"These new prospective data from a large-cohort study shows there is no evidence that eggs retrieved from a natural cycle are somehow healthier or have a higher chance of implantation than those retrieved from a stimulated or traditional IVF cycle," said Richard T. Scott, Jr., MD, FACOG, ALD/HCLD, laboratory director and a founding partner of RMANJ and co-author of the study. "Patients need to think twice. While the idea of a natural IVF cycle sounds appealing, it's still a very invasive and emotional process. In the end, these data make clear that success rates are significantly lower with natural cycle IVF and uses up infertility patients' most precious resource—time."

Dr. Scott added, "I'm extremely proud of our RMANJ researchers, physicians, nurses – our entire team for the time and expert effort they've put into collecting, analyzing and releasing this landmark research."

"Natural" IVF has been promoted by some U.S. fertility clinics over the last several years as a less expensive approach, with the main difference between it and traditional IVF being that ovarian stimulation medications are not used to help develop multiple eggs in the ovaries. Instead, "natural IVF" seeks to retrieve a single egg without stimulation which will be fertilized in the lab just like the traditional IVF process.

"This study contradicts conventional wisdom regarding the safety and efficacy of natural versus traditional IVF," said lead researcher and RMANJ physician Kathleen H. Hong, MD, FACOG, TS (ABB). "In related research, not only did we find in patients that embryos from both natural and stimulated cycles were of equivalent quality, but we also found that more than three out of four patients undergoing natural IVF didn't even get to embryo transfer." Dr. Hong added, "We sympathize with patients who are struggling to afford IVF care, but with natural IVF, patients will likely spend more time and money to achieve success."

"After undergoing both natural cycle and traditional stimulated IVF, I can wholeheartedly recommend traditional IVF to any woman seeking help in conceiving a healthy baby," said Laura Davis, who participated in the study. "I wanted to give natural IVF a try, but realize now that my best option for conceiving is traditional IVF. After my natural cycle was unsuccessful, the physicians at RMANJ were able to retrieve more than 20 eggs through the first stimulated 'traditional' cycle—eight of which were healthy embryos. We did a single embryo transfer and now have an incredible baby girl.

"I come from a family of six and was really hurting thinking I couldn't have a family," Ms. Davis added. "Just knowing that my husband and I have the opportunity to continue to grow our family with the remaining embryos gives us peace of mind and makes it all worth it."

Along with Dr. Scott and Dr. Hong, other RMANJ physicians on the research team included Eric Forman, MD, FACOG, HLCD/ALD; Marie Werner, MD, FACOG, TS (ABB); and Jason Franasiak, MD, FACOG, TS (ABB). The abstract will be published in the October 2016 issue of Fertility & Sterility, the scientific journal of the American Society for Reproductive Medicine.

METHODOLOGY
Between 2013 to 2015, researchers from RMANJ compared data from 369 patients who underwent natural IVF and 1,845 patients who underwent traditional, stimulated cycles. They found that 48 percent of "natural" IVF patients did not have a usable blastocyst and 78 percent did not have a euploid blastocyst to transfer – both significantly lower rates than those who underwent stimulated IVF cycles. Meanwhile, the overall aneuploidy rate per usable blastocyst were statistically equivalent between both groups: 44 percent of the blastocysts in natural cycles, compared to 42 percent of blastocysts in stimulated cycles. Most importantly, a euploid blastocyst had an equivalent chance of resulting in a delivery whether derived from a natural (58.7 percent) or stimulated (59 percent). 

Researchers also noted that "stimulated cycles often (result) in supernumerary euploid blastocysts vitrified for future transfer," resulting in "a dramatically higher opportunity for pregnancy per retrieval in comparison to natural cycles" – that is, traditional IVF procedures often led to better chances for achieving pregnancy.

ABOUT REPRODUCTIVE MEDICINE ASSOCIATES OF NEW JERSEY
The experts at RMANJ offer IVF delivery rates of 63.2 percent in women under 35 (n=886) and well above the US average*. Since 1999, they have helped bring nearly 40,000 babies to loving families. RMANJ has 25 physicians and 10 locations in New Jersey: Basking Ridge, Eatontown, Englewood, Freehold, Hamilton, Morristown, Somerset, Springfield, West Orange, and its newest location in Marlton, New Jersey. For more information, please call 973-656-2089 or visit www.rmanj.com.

RMANJ pioneered and successfully implemented a cutting-edge technology known as Select Comprehensive Chromosome Screening (SelectCCS) to more accurately detect healthy embryos that has led to successful pregnancies and ultimately healthy babies. SelectCCS is owned and operated by the Foundation for Embryonic Competence (www.feclabs.org) and offers advanced embryo selection with extreme accuracy by detecting and avoiding use of embryos with chromosomal abnormalities prior to transfer and pregnancy.

*SART 2014; Cumulative Outcome per Intended Retrieval; Preliminary Chance of Live Birth per Cycle. Please note: A comparison of clinic success rates may not be meaningful because a patient's medical characteristics, treatment approaches and entrance criteria for assisted reproductive technology (ART) may vary from clinic to clinic. Visit www.sart.org to learn more.

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SOURCE Reproductive Medicine Associates of New Jersey (RMANJ)

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