Benefits of Mini IVF
A Healthier Alternative
Comparable success with significantly less risk
An accepted part of IVF has been aggressive ovarian stimulation designed to produce as many eggs as possible. This approach is based on the largely unquestioned assumption that the more eggs that can be retrieved, the better. All of this was based on a simple statistical model: the more eggs we have, the better the chances of at least one good quality embryo leading to a successful pregnancy. But time, techniques, and attitudes have changed in the world of assisted reproduction.
What if we’ve gone too far down the road of “more is better” and lost sight of the needs of the patient – you – and your overall health, well-being, and peace of mind? Although there is no single medication protocol that is best in every case, there are many benefits of reduced stimulation fertility treatment.
In recent years there has been a growing interest in minimal stimulation fertility treatments, and they have been growing in demand and popularity. The ovarian stimulation medication used in conventional IVF has the single purpose of maximizing the number of oocytes (eggs) retrieved.
By contrast, a minimal stimulation protocol, or mini IVF, aims to reduce discomfort for the patient and to reduce the risk of an adverse reaction.
Typically, reduced stimulation IVF uses lower doses of stimulation hormones, less than 150 IU/day, or shorter duration, or both, compared with conventional protocols. The aim is to produce fewer than 8 oocytes, whereas conventional stimulation aims for higher egg yields, usually identified as more than 15.
Minimal stimulation is also more economical and therefore accessible to more people who need fertility treatment. Reduced stimulation can be used in connection with intrauterine insemination (IUI) or in vitro fertilization (IVF).
Pregnancy rates may be lower per cycle with reduced stimulation, but the cumulative pregnancy rate, over the number of cycles required for a successful result, is comparable between the two methods.
A US analysis of 470,000 cycles of conventional IVF found an overall drop-out rate of around 40% and the reason for this was primarily due to patient discomfort. There is no directly comparable study of drop-out rates from reduced stimulation IVF but it has been widely reported as significantly lower for those patients receiving mild stimulation compared with the standard protocol.
Some common reasons for discomfort during traditional IVF:
- Skin soreness or bruising at the site of daily hormone injections and frequent blood tests, or a generally heightened anxiety especially for those with a fear or dislike of needles.
- Generalized feeling of heaviness, bloating, or breast tenderness due to high levels of systemic hormones.
- A relatively rare complication known as OHSS (Ovarian Hyperstimulation Syndrome) which can range from mild discomfort and bloating to symptoms requiring hospitalization. While this is a rare condition, it is distressing for the patient and may require the whole cycle to be canceled.
As you can see, many of the discomforts that patients experience come from the hormones they receive. Mini IVF at Pearl, and other low to zero stimulation treatment cycles drastically reduce or eliminate many of these discomforts.
A randomized control study has shown that mild stimulation protocols are associated with a reduced level of anxiety and treatment-related stress and that patients experience fewer depressive symptoms after a failed IVF cycle with mild stimulation compared with failure after a conventional IVF cycle.
Conventional IVF medication can result in emotional distress, including mood swings and possibly even depression. These effects can be a result of the hormonal changes but also may result from the intensity of the process and the need for meticulous timing of medications and monitoring appointments. The strict timetable can cause anxiety about missing a scheduled injection and a feeling that the process has taken over your whole life!
The prospect of fewer oocytes resulting in fewer embryos also removes what can for some patients become a moral dilemma around what to do with the remaining embryos. With this additional concern removed, the patient and physician can focus simply on the desired outcome of one healthy child.
The exact cost of any fertility treatment will vary from patient to patient since the needs for precise levels of medication will vary according to the individual. However, the cost of reduced stimulation IVF is certainly lower than for conventional IVF, often around half the cost per cycle.
A reduced need for monitoring appointments and blood draws also results in lower costs to the patient as well as the savings from less travel and time off from work.
An often-overlooked factor when we think about the benefits of reduced stimulation is that, over the last 30 years since conventional IVF protocols became established, embryo selection techniques have improved significantly.
This means that embryologists are able to select a healthy embryo with a much higher degree of confidence that is capable of resulting in a healthy pregnancy. For this reason, the need for multiple oocytes as “insurance” is no longer such an important factor in a successful outcome.
For the majority of patients under 40 years of age with a normal ovarian reserve, low-stimulation fertility treatments like mini IVF can have excellent results.
Patients over 40 years of age may especially benefit from minimum stimulation IVF when previous conventional IVF treatments have resulted in immature or poor quality oocytes.
Women of all ages who have a reduced ovarian reserve are often unable to respond to the traditional IVF high-dose stimulation protocols therefore, the additional discomfort, stress, and cost are wasted. These patients typically respond very well and find success with low-stimulation fertility treatments.