If you’re thinking about a round of in vitro fertilization, or you’ve undergone one (or more) already, you know that it’s an ordeal. Not only is it hugely expensive, but the procedure requires numerous doctor’s visits for blood draws and ultrasounds, injections, oral medications, and what can be pretty much unlimited amounts of worry.
An article in the new issue of Fertility and Sterility asks physicians (and patients) to reconsider the less-common protocols of mild-stimulation IVF and minimal stimulation IVF - two different procedures. The authors, led by Suheil J. Muasher, M.D., of the Muasher Center for Fertility and IVF, in Fairfax, Virginia, define mild stimulation as the use of “a low dosage of gonadotropins to produce a maximum of 10 oocytes” (eggs). Dr. Muasher and his co-authors cite evidence that pregnancy rates with mild-stimulation IVF are comparable to IVF using higher doses of gonadotropins. Mild-stimulation IVF is, though, unlikely to allow you to get extra eggs to freeze if you want to try again in the future. On the flip side, chromosomal problems and multiples are more common in pregnancies using regular IVF.
The article also discusses a very different (but similar-sounding) approach: minimal-stimulation IVF, which the authors describe as typically meaning a stimulation protocol that yields no more than five eggs. In comparing their own minimal- and full-stimulation “low-responding” IVF patients at the Muasher Center in 2009 and 2010, the researchers found that 42% of minimal-stimulation patients had a clinical pregnancy, which compares well to the 47% success rate they found for women receiving the full-stimulation approach. These encouraging statistics for minimal-stimulation IVF are particularly useful for women and couples who are without insurance to cover ART, since minimal-stimulation IVF costs much less (Dr. Muasher says that between savings in medications, ultrasounds, bloodwork, and medication, patients can save more than $5,000, plus they'll have less stress and need less time off from work). It can also be useful in helping women at risk of ovarian hyperstimulation syndrome (OHSS) avoid this condition, which is brought on by the high doses of gonadotropins.
Talk to your doctor if you’re considering mild- or minimal-stimulation IVF, to find out if it might be right for you.
If you've used minimal-stimulation or mild-stimulation IVF what was your experience like?