Minimal Stimulation IVF: Do the Benefits Outweigh the Risks?
1978 saw the birth of the first in vitro fertilization (IVF) baby, which you may know as the first “test tube baby.” Back then doctors did not prescribe the fertility drugs that are now commonly used by women using IVF. In other words, a large amount of fertility medications are not always required for IVF to succeed.
IVF without a lot of drugs?
Minimal stimulation IVF (also known as Mini IVF or Micro IVF) offers infertile couples an alternative to traditional IVF. Some people like that Mini IVF differs from standard IVF because it:
- Has you taking less medication
- Costs less
- Requires less time commitment
Pregnancy rates may be lower with Mini IVF, but some couples still choose this method due to its other benefits.
Mini IVF explained
Here's a rundown of what to expect with Mini IVF, although procedures can vary from clinic to clinic:
- Before starting Mini IVF, you may take at least one round of birth control pills to regulate your cycle.
- Your doctor will perform an ultrasound to make sure that you are a good candidate for IVF.
- If everything looks healthy, your doctor may prescribe clomiphene citrate to boost ovulation, encouraging your body to produce more eggs than normal.
- Once your follicles are fully ripe and mature, your doctor will administer a human chorionic gonadotropin (hCG) injection.
- IVF will proceed in the traditional way, with egg retrieval, fertilization, and embryo transfer.
If you choose Mini IVF, you will still take some fertility drugs. You will simply take less of them. For instance, you can avoid the daily injections common with standard IVF cycles. Avoiding injections may reduce your risk of ovarian hyperstimulation syndrome (OHSS). OHSS is a serious problem that sometimes occurs with standard IVF treatment.
Will Mini IVF help me get pregnant?
Minimal stimulation IVF may be more likely to result in pregnancy than natural cycle IVF, which uses no fertility medications at all. Yet Mini IVF success rates are often lower than standard IVF success rates. A small study by researchers at Bellingham IVF and Infertility Center found Mini IVF pregnancy rates to be similar to those of standard IVF. But don’t let this study mislead you. In this study of 32 women, all of the women had tubal factor infertility and were under 40 years of age. Out of 64 retrievals, there were 21 pregnancies. Thus, 1 in 3 Mini IVF cycles in the study yielded a pregnancy, but the women took about 3 cycles to conceive. Other sources report Mini IVF success rates to be closer to 10 percent per cycle. This is far lower than standard IVF pregnancy rates, which range from 30 to 47 percent nationally.
Why doesn't everyone do Mini IVF?
Minimal stimulation IVF is controversial, and not all clinics offer this service. Here are some critiques of the procedure:
- With Mini IVF your doctor may only be able to retrieve between 2 to 4 eggs for fertilization and there is an increased chance that no eggs will be retrieved at all.
- With standard IVF your doctor may be able to retrieve between 8 and 15 eggs. Fewer eggs can mean lower success rates.
- Your IVF cycles may be more likely to be cancelled.
With fewer eggs, you will probably not have any remaining embryos to freeze. Compare this to standard IVF treatment, where you can often freeze embryos that are not transferred that cycle. Freezing embryos can save you from repeating ovulation stimulation and egg retrieval in the future if you do not get pregnant during that IVF cycle. For these reasons, among others, some doctors will not perform Mini IVF.
So why try Mini IVF?
Some women can't, or don’t want to, take many fertility medications. For these women, Mini IVF may be an appropriate alternative. Supporters claim that Mini IVF costs less, has fewer side effects, takes less time, and is more comfortable than standard IVF. Critics say that you may never see these benefits of Mini IVF since you may just have to do more IVF cycles until you become pregnant.
Many couples are eager to find ways to reduce the cost, time commitment, and side effects of standard IVF. These couples may consider Mini IVF, even with its lower success rates. Mini IVF may be right for you if you:
- Are under 35
- Have tubal factor infertility
- Do not have male factor infertility
- Cannot tolerate the injections of traditional IVF
- Have diminished ovarian reserve and don't respond well to gonadotropin injections
If Mini IVF sounds appealing, ask your doctor if your fertility clinic offers this procedure.
Something to keep in mind, however, is that you will not be eligible for IVF programs, like Attain IVF, since the success rates are dramatically lower.Sources
- Fertility and Sterility: Minimal stimulation IVF using clomiphene citrate and oral contraceptive pill pretreatment for LH suppression
- American Society of Reproductive Medicine: Fertility and Sterility: Patient-Friendly IVF: How Should It Be Defined?
- Shady Grove Fertility: Natural Cycle IVF
- Society for Assisted Reproductive Technology: Minimal Stimulation IVF-ET
- Society for Assisted Reproductive Technology: SART National Summary