Embryo Transfer: Natural vs. Medicated Cycles
There’s more than one way to prepare the body for transfer, and the approach depends on patient and provider preference, menstrual cycle history, other aspects of the patient’s medical history, and the clinic’s protocols. The two most common methods are natural cycle transfers and medicated (programmed) transfers.
Natural Cycle Transfer
This option works with your body’s rhythm. If you have regular periods and ovulate consistently, your clinic can align the transfer with your natural cycle.
How it works:
You’ll go in for bloodwork and ultrasounds so your team can track follicle growth and predict ovulation.
Some clinics use a trigger shot to help control timing, but often your body’s natural LH surge sets the schedule.
Once ovulation is confirmed, the transfer is timed to match the embryo’s age (a day-5 blastocyst, for example, is placed 5 days after ovulation).
Progesterone support may or may not be prescribed, depending on your clinic.
Why people choose it:
It feels “lower intervention” and relies on your body’s own hormone production. But because timing depends on your natural cycle, flexibility is limited and you’ll likely have more monitoring visits.
Medicated (Programmed) Transfer
This option uses hormone therapy to prepare your uterine lining, which gives the clinic (and you) more control over timing. It’s often recommended for people with irregular cycles, menopausal patients, history of failing or likely to fail a natural cycle transfer, or those who want a more predictable timeline.
How it works:
You’ll start with estrogen (pills, patches, or injections) to thicken the uterine lining.
Once the lining looks ready (usually ≥7–8mm on ultrasound), you’ll add progesterone.
The number of days on progesterone is carefully matched to your embryo’s age. For example, a day-5 embryo is transferred after 5 days of progesterone.
Progesterone continues after transfer to support implantation until the placenta takes over hormone production in early pregnancy.
Why people choose it:
Medicated cycles make scheduling easier and give your care team more predictability. They do, however, mean taking daily hormones (sometimes injections).
Key Differences at a Glance
| Feature | Natural Cycle | Medicated Cycle |
|---|---|---|
| Ovulation | Your owntd> | Suppressed/not needed |
| Estrogen | Sometimes added | Always required |
| Progesterone | Sometimes added | Always required |
| Flexibility | Depends on your cycle | Highly scheduled |
The Bottom Line
Both paths aim for the same goal: giving your embryo the best possible chance to implant and both have the same pregnancy outcomes. The choice often comes down to what fits your body and your life. If your cycles are regular, a natural transfer may feel simpler. If you need flexibility, or if your clinic wants more control, a medicated cycle may be the best fit.
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