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Can you get pregnant naturally during IVF cycle?

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8 fertility expert(s) answered this question

Is there a possibility of getting pregnant during an IVF cycle naturally?

Our experts have answered questions about conceiving naturally during IVF treatment. Learn how natural conception alongside IVF is possible, though rare. They also clarify whether sexual activity is recommended during fertility treatment for your peace of mind.

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Answer from the fertility expert:
Dr Serap Kağan, IVF Specialist & Medical Director, Cyprus IVF Hospital

It is possible to conceive naturally during an IVF cycle, although the primary aim of IVF is to override the natural conception process. There remains a small possibility of an unexpected pregnancy. However, due to the medications administered during IVF, which regulate the cycle and suppress ovulation, the chances of this happening are quite slim. While nothing is ever 100% certain, the procedure is specifically structured to manage egg release and fertilization in a controlled environment.

Understanding the IVF Cycle

During an IVF cycle, several key steps are involved:

  1. Ovarian Stimulation: Fertility medications are used to stimulate the ovaries to produce multiple eggs.
  2. Egg Retrieval: Once the eggs are mature, they are retrieved from the ovaries through a minor surgical procedure.
  3. Fertilization: The retrieved eggs are fertilized with sperm in the laboratory.
  4. Embryo Transfer: One or more embryos are selected and transferred into the woman’s uterus.

The process is highly controlled, with specific timing for medication, monitoring, and procedures. The goal is to maximize the chances of a successful pregnancy through controlled methods rather than natural conception.

Possibility of Natural Conception During IVF

While the primary focus of an IVF cycle is on the controlled environment created for fertilization and embryo transfer, natural conception can theoretically occur under certain circumstances:

  1. Spontaneous Ovulation: If the IVF medications induce the production of multiple eggs, there might be a possibility of spontaneous ovulation of an additional egg. If intercourse occurs around the time of ovulation, natural conception could occur. However, this scenario is rare due to the precise timing and control involved in IVF cycles.
  2. Timing of IVF Procedures: The timing of egg retrieval and embryo transfer is meticulously planned. Any natural conception would need to coincide with the timing of these procedures, which is unlikely given the focus on the IVF process.
  3. Unpredictable Variables: In some cases, hormonal fluctuations or other factors could lead to spontaneous ovulation and possible natural conception. Other factors, such as stress or underlying medical conditions, could also contribute to this unpredictability. However, these occurrences are very rare and are typically detected during routine monitoring appointments. Fertility specialists

closely track hormone levels and follicular development throughout the IVF process, which would allow them to identify any early signs of ovulation or deviations from the expected response to treatment. If any irregularities are spotted, adjustments to the protocol can be made to prevent complications.

Medical and Practical Considerations

  1. Controlled Environment: The IVF process is designed to control and optimize conditions for conception, making natural conception less likely. The use of fertility medications and the focus on laboratory fertilization generally override natural reproductive processes.
  2. Monitoring and Supervision: During an IVF cycle, patients are closely monitored for ovarian response and follicle development. Any indication of natural ovulation or conception would likely be identified during these assessments.
  3. Potential Risks: Attempting to conceive naturally during an IVF cycle could lead to complications, such as ovarian hyperstimulation syndrome (OHSS) or issues with the synchronization of IVF procedures. It is essential to follow the IVF protocol as advised by the fertility specialist to avoid any risks or disruptions.

While it is theoretically possible to conceive naturally during an IVF cycle, the highly controlled and monitored nature of IVF makes it unlikely. The primary goal of IVF is to manage and optimize fertility through specific protocols and procedures, which typically exclude natural conception. Couples undergoing IVF should focus on the prescribed treatment plan and discuss any concerns or questions with their fertility specialist to ensure the best possible outcome for their fertility journey.

Answer from the fertility expert:
Harry Karpouzis, Founder & Scientific Director, Pelargos IVF Medical Group

Yes, it is possible to get pregnant naturally during an IVF cycle. While the goal of IVF is to bypass the natural conception process, there’s always a chance of unintended pregnancy.

Here are a few reasons why natural pregnancy might occur during an IVF cycle:

  •  Ectopic pregnancy: If a fertilized egg implants outside of the uterus, it’s considered an ectopic pregnancy. This can sometimes happen even when IVF is being performed.
  •   Ovulation: If you ovulate naturally while undergoing IVF, there’s a chance that sperm could fertilize an egg outside of the lab, leading to a natural pregnancy.
  • Most of the medication that suppresses ovaries before and during IVF, like GnRH agonists, usually work as contraception too, but these do not have 100 % efficacy.

To minimize the risk of unintended pregnancy during IVF:

  •  Follow your doctor’s instructions carefully. This includes taking prescribed medications as directed and avoiding sexual activity during specific periods.
  • Use reliable birth control methods, before IVF, if that is suggested by your doctor.
  • Communicate openly with your fertility specialist. If you have any concerns or questions.
Answer from the fertility expert:
Valentina Denisova, Fertility Specialist, Next Generation Clinic

It can happen. And sometimes we can face such a situation, especially when we’re performing frozen embryo transfer in a natural cycle. So, we have a growing follicle and if a woman has good tubes and her partner has sperm, they can conceive naturally even while on an IVF process. And of course, a person can get pregnant during ovarian stimulation. So if you have tubes you should use some contraception during ovarian stimulation. And this contraception should be condoms; not hormonal, but barrier contraception.

Answer from the fertility expert:
Tomas Frgala, Head Physician at UNICA Clinic - Brno, Unica Clinics – Prague and Brno

There are numerous variations to the IVF cycle to the In Vitro Fertilization, to the assisted reproduction protocol. Perhaps during some, such as the natural cycle, you might be able to get pregnant naturally but usually a part of the protocol is actually blocking the hormones of the woman so that the growing follicles with the ripening eggs would not rupture spontaneously – we need to prevent this from happening (this is natural spontaneous ovulation) so that we can actually harvest the eggs during the oocyte pickup and there are various medications that are applied (some even prior to the stimulation) but usually it’s during the stimulation which affect that. So during the stimulation itself that would be quite unlikely because we mix and play a little with these hormones. But prior to the stimulation cycle, it’s not unusual – especially with most often used antagonist protocol where the stimulation starts from day two of the cycle and it happens every now and then that we prepare everything for the cycle, the protocol, the medications and then wait for the menstruation. Sometimes the menstruation doesn’t come, sometimes the couple actually gets relaxed, they stop to try, they feel okay now we’re in the hands of the physicians or the specialists and let’s just wait what happens and sometimes this relaxed attitude leads to the spontaneous fertilization or conception.

Answer from the fertility expert:
Matthew Prior, Reproductive Medical Consultant, Founder of The Big Fertility Project

I’m gonna say the answer is no because it shouldn’t really happen but I have seen people who have turned up for an IVF cycle, even started their first medication and they’ve done a positive test and you do a scan and there’s an early pregnancy. So you can never say never to anything 100% but it’s very unlikely you’ll get pregnant naturally during an IVF cycle because you will be having medications to manipulate the cycle, so that you don’t ovulate and release an egg. Because the idea is – you want to collect them. It also would be very dangerous, for example, if you didn’t go on and have an egg collection but were still taking the medications because then you could potentially ovulate lots of eggs and then there’s a really big risk of multiple pregnancies. This is when you sometimes see horror stories on the news of like three, four, five, six, seven babies and that can really cause major problems in pregnancy. Definitely need to be really careful having sex during an IVF treatment. Most places would recommend using barrier contraception.

Answer from the fertility expert:
Santiago Eduardo Novoa, specialised in Reproductive Medicine, Instituto iGin

The answer is yes. You can get pregnant during an IVF. It depends on which protocol has been chosen and of course if you get to the ovarian retrieval sometimes small eggs are left in the ovaries, they are not punction. The answer is that you can get pregnant during an IVF but it’s never a good idea because that exposes you to an increased risk of multiple pregnancy and I mean not only between pregnancy but higher order pregnancy three four or whatever you can. Time ago it was not infrequent that the patient was getting pregnancy but was getting pregnant but that was before the start of the IVF is related with the long protocols, basically the long luteal protocol so the answer is yes you can get pregnant but if it is during the stimulation you should not get pregnant because that could mean a higher order pregnancy.

Answer from the fertility expert:
Delphine Dewandre, Senior Embryologist, Beacon CARE Fertility

That is always a possibility. I would really not recommended it. Normally when you are going through the treatment and ovaries are stimulated, you must take into account that it is not like in normal way it would happened. You don’t have only one egg mature but there might be 5 to 8. If you would have unprotected intercourse at that time and it would work, it would be very dangerous as it might be that not only one embryo will be created but eight ot more. If you would have sexual intercourse during IVF process better be protected.

Answer from the fertility expert:
Raúl Olivares, Medical Director & Owner, Barcelona IVF

Theoretically, it is possible but very unlikely.  The main reason is when patients are undergoing IVF,  we usually recommend not to have sex during the process. Not because that could be a problem because obviously in natural circumstances if you don’t have sex, you cannot get pregnant. Sex itself is not an issue, but when the ovaries are stimulated, and we have done the egg collection, they tend to be tender, there is a risk of bleeding, and then we recommend avoiding sex until the day of the pregnancy test.

However, there have been natural pregnancies described, for example, in cryotransfer cases in which the natural cycle has been used. That means that we just check how the follicle grows, and on the day the follicle reaches 17-18 millimetres, we trigger the ovulation. Then, 5 days after that ovulation, we schedule the frozen embryo transfer, and the patients can have had sex in this cycle because it is not contraindicated. There is no hyperstimulation of the ovaries, and then despite transferring 1 embryo,  there have been twins on the scan. That means that very likely the patients have got pregnant at the same time by the embryo that we have transferred and by the egg that the woman has ovulated. We know that because later has been confirmed that they were non-identical twins. Sometimes, we transfer an embryo, and the embryo can split into 2, but in these cases, they were babies of different gender, so a boy and a girl, so that means that they come from different eggs and if only transfer 1  embryo, that’s not possible.

Because of the short cycles that we use in IVF,  it is not so common to happen as when we were working with long protocols. In long protocols, it sometimes happened that we started with a down-regulation before the patient even had the period, and in some cases, the patients didn’t have the period, and that was because they got pregnant.  It wasn’t risky, there weren’t any problems with the pregnancy. Nowadays, most of the cycles are started on day 1 of your period, which means that if for any reason you get pregnant in the previous cycle of the IVF,  you are not going to have a period, you are not going to start.

It is very unlikely to get pregnant naturally during the IVF cycle, it is not impossible and only in some specific cases like transfers within natural cycles.

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