
Natural FETs outperform medicated FETs in donor egg cycles
Researchers in a 2026 study found that natural FETs using donor eggs were linked to higher live birth rates, lower miscarriage rates, and lower rates of some pregnancy complications compared to medicated FETs.
For a frozen embryo transfer, the uterine lining can be prepared using the body’s own hormones (natural FET) or with estrogen and progesterone medications (medicated FET).
A study by Rafael et al. (2026) looked at more than 67,000 donor egg transfers. Donor eggs were used to help control for egg quality differences, which can strongly affect IVF success rates and make these comparisons harder to interpret.
The researchers found better outcomes with natural FETs, and age didn’t appear to change the results.
One possible reason is the corpus luteum, which is present in natural FETs but absent in medicated FETs. It produces factors that help support implantation and placental development during early pregnancy.
The researchers also found that natural FETs still performed better even when medicated cycles used progesterone monitoring and “rescue” progesterone to correct low levels.
Overall, this study adds to growing evidence that natural FETs may provide a more beneficial environment for implantation and pregnancy, while also reducing complications.
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