Natural FET Cycle (Frozen Embryo Transfer)

This month we are doing a natural FET (frozen embryo transfer) cycle instead of a medicated cycle. 

In a medicated cycle you take medication like estradiol or Estrace as estrogen support to help encourage the growth of your uterine lining. This starts at the beginning of your cycle.

For a natural cycle you wait to do any medications and just let your body do its thing- growing your lining. 

Around ovulation you’ll add in progesterone support, either suppositories or progesterone in oil (PIO) shots.

Please note: I am not a medical professional. This content is for informational purposes only and is not intended to treat or diagnose any conditions. Always consult your doctor or medical professionals. Full disclaimer available here.

My experience:

Since my endo excision surgery we’ve had 2 canceled FET cycles.

The first one was a medicated cycle. 

We found that my uterine lining didn’t thicken as well as my doctor wanted. It was around 8mm at the time of transfer. And I was taking estradiol three times a day.

When we got to our transfer, he also noticed fluid in my lining. 🤷‍♀️

That was something completely new for me. I didn’t know that was a thing to even look for!

And it hadn’t been there at my prior monitoring ultrasound.

The second cycle we tried a natural cycle. 

Without the medication my lining grew much better and was thicker at 10mm. 

We had to cancel it because I ovulated and we needed to start the PIO shots before ovulation.

Of course this was disappointing, but I was glad to know that my body did a better job growing a nice lining than the previous cycle. The one where I took estradiol 3 times a day.

This month we’re doing another natural FET cycle.

I thought it might be helpful to give you an overview of what this cycle has looked like for me, in case you find yourself doing a similar cycle or protocol.

The first two weeks of my cycle were uneventful. 

I took an aspirin (81mg) each day, but that was it. 

No shots.

No estradiol.

I did take my thyroid medication (levothyroxine) and regular vitamins each day, but for this post I’ll just be sharing my natural FET meds and protocol.

My first ultrasound and bloodwork happened on cycle day (CD) 13.

If you have a regular 28 day cycle this would be just before ovulation if you normally ovulate on CD 14.

Here’s why it helps to know about your cycle-

My cycles average 35 days, or 5 weeks. So, my ovulation is a little later in my cycle, around day 18.

It definitely helped being able to share with my doctor and nurses when my ovulation usually happens so that we didn’t miss it again.

I didn’t know about the medication timing with my cycle for our first natural FET, which contributed to missing my ovulation and canceling the cycle.

I went in 2 more times for monitoring ultrasounds and bloodwork.

It was a long week of driving back and forth.

My doctor wanted to get my lining to a good thickness, but not miss my ovulation again.

Natural FET Cycle: Cycle Day 15-

 At my second monitoring appointment my lining wasn’t quite where he wanted but my bloodwork showed a rise in my LH level.

CD 16-

At the third appointment (a Friday) my lining was looking even better. Based on my LH levels it looked like I was gearing up to ovulate that day but definitely over the weekend.

One of the nurses drew circles for the PIO shot locations so that we’d be ready.

After my bloodwork results came back, one of the nurses called me with the go-ahead to begin our PIO shots. 

I also began taking Medrol (methylprednisolone) at 16mg, once a day for 7 days (CD 16-22)

The nurse explained that the Medrol is supposed to help your body prepare to accept the embryo, and not reject it.

At this point I started using my IVF tracker to make sure I took everything I need each day. I took a couple in the morning and the rest at night. 

After a few days it can be tricky to remember what I took and which side the shot was on. Frankly, it’s not where I want to focus my brain power. By jotting it down I don’t have to worry about it.

CD 17-

I began taking 2mg of estradiol, once per day.

This medication protocol will be continued until I’m told to stop. Basically through 10 weeks of pregnancy or with a negative pregnancy test.

CD 20-

My nurse navigator sent my transfer time and instructions.

She also reminded me to sign some consent forms 😬. Consider this your reminder to look over and sign all your forms!

CD 21- Embryo transfer!

Two Week Wait (TWW)

There’s a lot of waiting when it comes to fertility cycles. So… Much… Waiting.

Overall FET cycles are more relaxed than a full IVF cycle with stims and egg retrieval.

There’s less medication (i.e. fewer shots) and fewer monitoring appointments.

I’ve really liked not having to take as much medication this cycle.

During the medicated cycle we did a couple months ago I had to set several reminder timers to take the meds at the same time each day. This cycle I just have my evening reminder.

With the medicated cycle I noticed more mood swings and crankiness. I was taking 2mg of estradiol, 3 times a day.

Organizing Natural FET Cycle Meds

It can be tricky to keep organized so I like to keep everything together in a little bin.

I just grabbed a clear container that we already had, but you can get a special bin if you want.

I keep my levothyroxine and aspirin bottles by my bed so that I remember to take them in the morning.

After I’ve taken them I flip the bottle upside down as a signal to myself.

In my FET container I have everything else:

• Medrol/ methlprednisolone
• Estradiol 
• Progesterone in Oil
• PIO Syringes
• Needles
• Alcohol Prep Pads
• Sharps Disposal Container
• Pouch for taking meds on-the-go
• IVF Tracker

When the time comes for my evening meds, I wash my hands and grab my container. Easy peasy.

I usually take the orals while Josh preps the shot.

When it’s time for the injection, I use these tips to make it less painful.

Good Luck! 🍀 

I hope this peek at a natural FET cycle has given you an idea of what to expect for your cycle.

Remember, your meds and dosages will be determined by your doctor based on your specific needs.

If you’re preparing for Progesterone in Oil shots, this post will give you tips to make them easier and less painful. And check out this post for affirmations for embryo transfer.

I’m sending you all the baby dust and positive vibes!

You’ve got this!