Under normal conditions, 1 or rarely 2 egg cells mature every month in the ovaries and are released into the female reproductive system for fertilization. The main purpose of IVF treatment is to mature as many eggs as possible, to harvest them, to combine them with sperm cells and to create quality embryos. Therefore, the ovaries are stimulated with hormonal drugs. After the ovaries are stimulated, egg development is monitored Maturing egg cells are collected before cracking. The eggs taken from the woman are brought together with sperm in a laboratory environment using the traditional IVF or ICSI method. After the sperm and egg meeting takes place, embryos are expected to form.
In drug-free IVF treatment, also called In Vitro Maturation, women are not given high-dose hormone medication to stimulate the ovaries. A very low dose of gonadotropin hormone can be used, or without the use of any hormonal therapy, "immature" egg cells are harvested from the ovaries.
Immature egg cells collected from the ovaries are matured outside the body, in the laboratory, inside a culture using hormones or oocyte protein dimer called 'cumulin'. For fertilization of maturing eggs, ICSI method is usually resorted to. With the ICSI method, quality sperm cells are mechanically placed in the cytoplasm of mature eggs, and if embryo formation is observed, embryo transfer is performed at the right time.1
Drug-Free IVF Treatment, medically known as in vitro maturation (IVM), is a method that may be considered as an alternative to conventional IVF treatment in selected patients. In this approach, instead of stimulating the eggs to grow with intensive hormone therapy, immature eggs are collected and matured under laboratory conditions.
In the ASRM committee opinion on IVM, it is stated that the method may be considered especially for selected patient groups who are at risk for OHSS or for whom controlled ovarian stimulation may not be appropriate.
The term “drug-free” does not mean that the treatment proceeds without any medication in every patient. The main difference in IVM is that the eggs are matured in the laboratory environment rather than through intensive hormonal stimulation.
For couples researching drug-free IVF in İzmir, the first step is to determine whether this method is truly appropriate for them. In drug-free IVF evaluations performed by Assoc. Prof. Dr. Funda Göde, the treatment decision is made by considering the woman’s age, ovarian reserve, presence of PCOS, sperm analysis, and previous treatment history together.
Drug-free IVF, medically called in vitro maturation, is an IVF approach in which eggs are matured outside the body. In conventional IVF, the ovaries are stimulated with hormonal medications and mature eggs are collected. In the IVM method, immature eggs are retrieved, matured in a special laboratory environment, and the suitable ones proceed to fertilization with sperm.
“When people hear the term drug-free IVF, they may sometimes think that this method requires no medical preparation at all. However, the main difference here is that the eggs are matured under laboratory conditions instead of being stimulated with intensive hormones as in conventional IVF. The suitability of the treatment is determined by evaluating the patient’s ovarian structure, age, and chances of pregnancy together.”
The answer to the question “Who is suitable for drug-free IVF?” varies according to the patient’s medical characteristics. IVM treatment is mainly considered in selected patient groups where intensive ovarian stimulation with hormonal medications is not desired or requires careful evaluation.
These groups include women diagnosed with PCOS, patients with polycystic ovary-like ovarian structures, those at high risk of OHSS, and some cancer patients who require urgent fertility preservation planning.
PCOS, or polycystic ovary syndrome, is a condition associated with the presence of many small follicles in the ovaries and irregular ovulation. In these patients, when the ovaries are stimulated during conventional IVF, the risk of OHSS may become an issue that requires more careful management throughout the IVF process.
For this reason, in PCOS drug-free IVF evaluations, the goal may be to offer an option involving fewer medications. However, this does not mean that IVM will be the first choice for every woman with PCOS.
“We do not make the decision for drug-free IVF based on a single diagnosis alone. While the presence of PCOS provides important information regarding how the ovaries may respond and the chances of pregnancy, the treatment plan becomes clear only after all of the patient’s data are evaluated together.”
Drug-free IVF is not a routine option for every couple. Different treatment plans may be considered in patients with very low ovarian reserve, where the expected number of immature eggs that can be collected is limited, or where the chances of obtaining embryos may be higher with conventional IVF.
In cases with significant male factor infertility, severely affected sperm parameters, or situations requiring genetic testing, decisions should also be made based on individual patient data.
Before starting treatment, the goal is to determine whether the method is suitable for the patient. In this evaluation, the woman’s age, menstrual pattern, ovarian reserve, uterine structure, tubal status, and sperm analysis are considered together.
At the initial stage, hormone tests are generally requested. AMH is one of the tests that provides information about ovarian reserve. The antral follicle count is evaluated by ultrasound, helping assess the small follicles in the ovaries that may respond to treatment.
Ultrasound is one of the basic examinations used to evaluate the uterine cavity. In necessary cases, additional evaluations such as hysterosalpingography (HSG), hysteroscopy, and infection screening may be planned.
A sperm analysis is performed, and sperm count, motility, and morphology may affect the treatment plan. In some couples, genetic evaluation or additional investigations may also be considered.
The answer to the question “How is drug-free IVF performed?” may vary depending on the IVM protocol used. In the basic approach, the ovaries are first evaluated by ultrasound. The goal is to collect the eggs at the appropriate time before they become fully mature. These eggs are then placed into a special culture medium in the laboratory and monitored until they reach maturity for fertilization.
The drug-free IVF treatment process generally proceeds through the following stages:
One of the prominent features of IVM is that it can be performed without the need for intensive ovarian stimulation used in conventional IVF, or with lower medication support. This may allow for a more controlled treatment process, especially in patients whose ovaries may respond strongly to hormonal medications.
Possible advantages can be summarized as follows:
“Using fewer medications may make the treatment feel easier; however, the primary goal when making a decision is to protect the patient’s safety while realistically evaluating the chances of pregnancy. Therefore, although IVM can be a valuable option in suitable patients, it must be carefully planned so that it does not lead to loss of time in unsuitable cases.”
The success rate of drug-free IVF varies depending on age, ovarian reserve, the presence of PCOS, sperm characteristics, the IVM protocol used, and embryo development. Therefore, it is not appropriate to provide a single success rate applicable to all patients.
In a randomized study conducted in women diagnosed with PCOS, the ongoing pregnancy and live birth rate within 6 months was reported as 22.3% in the unstimulated IVM group and 50.6% in the standard IVF group. In this study, single blastocyst transfer and a freeze-thaw approach were used. The researchers stated that, in this protocol, one cycle of unstimulated IVM resulted in a lower live birth rate compared to standard IVF.
What should be considered after the drug-free IVF process varies depending on the stage of treatment completed. Mild groin pain, spotting, or temporary sensitivity may occur after egg retrieval. In cases of severe pain, heavy bleeding, fever, or significant abdominal swelling, the clinic should be contacted.
If embryo transfer has been performed, the prescribed medications should be used exactly as recommended by the physician. A pregnancy test is generally scheduled on specific days after the transfer. If the result is positive, ultrasound follow-up is performed to evaluate the gestational sac and fetal heartbeat.
Recommendations during this period generally include:
Most patients can return to daily life within a short period; however, the exact plan is determined according to the procedure performed and the patient’s clinical condition.
During the initial consultation for drug-free IVF treatment in İzmir, ovarian reserve, the presence of PCOS, hormone levels, ultrasound findings, and sperm analysis are generally evaluated together. This assessment helps determine whether IVM or conventional IVF may be the more appropriate option for the couple.
Cost considerations also vary from couple to couple. Drug-free IVF prices in İzmir may be affected by the protocol used, laboratory procedures, embryo freezing requirements, transfer planning, and additional tests. Therefore, exact information can only be provided after a personalized treatment plan has been created.
Before starting treatment, it is important to evaluate individually whether IVM is the right option for you. To create a personalized roadmap regarding IVM treatment, IVF planning, and current treatment costs in İzmir, you may contact the clinic of IVF specialist Assoc. Prof. Dr. Funda Göde.
In IVF, eggs are retrieved from small follicles following ultrasound monitoring of the ovaries. These eggs are often not yet ready for fertilization, so they are placed in a special culture medium in the laboratory to allow them to mature.
The number of eggs varies depending on the patient’s ovarian reserve, the number of follicles, and the protocol used. In IVM, the goal is to retrieve eggs that have not yet fully matured and to allow them to mature in the laboratory. For this reason, the number of eggs retrieved may not be the same as the number of eggs that become suitable for fertilization.
IVM may be an option to consider in patients at high risk for OHSS. The extent to which the risk changes should be assessed based on the patient’s PCOS status, AMH level, ovarian response, and the protocol used. It is not accurate to state definitively that the risk is completely eliminated.
The process does not always proceed entirely without medication. While some IVM protocols do not involve ovarian stimulation, others may use short-term or low-dose medication support. For this reason, the term “medication-free IVF” refers primarily to a treatment approach that proceeds without intensive hormonal stimulation.
It is not as widely used as conventional in vitro fertilization (IVF). IVM is a specialized procedure that is evaluated in selected patient groups and at centers with experience in this field.
IVM is not considered a more successful method than conventional IVF for every patient. Some studies have reported that live birth rates are lower with IVM—particularly in stimulation-free IVM protocols—compared to standard IVF.
In Izmir, the process can begin by scheduling an initial consultation for evaluation. During the first consultation, we will review your age, menstrual cycle, ovarian reserve, history of PCOS, previous treatments, and sperm analysis. Following this evaluation, we will determine whether the medication-free IVF method is appropriate for you.
The duration varies depending on the protocol used and the embryo transfer plan. If an embryo transfer is scheduled, the process continues based on embryo development and uterine preparation.
Note: This content is for general informational purposes only and does not replace diagnosis or treatment. A physician evaluation is required for personal diagnosis and treatment planning.
