Usually, less than 10 eggs are retrieved during a mini-stim IVF cycle. But keep reading, there’s way more to know!

Mini-stim, or minimal stimulation IVF, is a ‘natural’ type of fertility treatment that is growing in popularity and is particularly attractive to those who want a gentle form of IVF that uses less medication to grow the eggs in a woman’s ovaries.

In mini-stim, doctors prescribe fewer injectable medications than in traditional IVF and focus more on oral medication. The result, as you may have guessed, is fewer eggs retrieved after an egg retrieval procedure.

But how many fewer? That all depends on the woman and her ovarian reserve. As a rule of thumb, it’s pretty rare for women pursuing mini-stim - even younger women with robust ovarian reserves - to net ten or more eggs after a cycle (although there are some exceptions for women with Polycystic Ovary Syndrome, or PCOS, who could produce more than ten eggs in one cycle).

More commonly, a woman will produce about five to eight retrievable eggs through this gentler type of treatment. In traditional IVF, however, women often walk away having retrieved 15 or 20 eggs, sometimes more. The exact number of eggs retrieved during a mini-stim cycle will depend on the woman’s age, her medication protocol (tweaking the specific amount and type of hormonal medication often alters the result), her ovarian reserve (the quality and quantity of eggs inside her ovaries) and whether she has any reproductive conditions, such PCOS.

But first, let’s just go through a quick review on what IVF is, anyway.

How does IVF work?

IVF is the process of pairing two cells – one egg and one sperm – outside the human body (in a small dish) in order to create an embryo that can be transferred into a woman’s uterus in hopes of achieving an ongoing pregnancy. Sounds simple enough, but in order to join egg and sperm, you need to get egg and sperm.

In order to be efficient, it makes sense to get several eggs and sperm at once that can be used for IVF. For sperm, ejaculation is fairly straightforward. But for eggs, it’s not so easy – they never actually come out of the female body, and when ovulation occurs, only a single egg is released. What starts with a batch of eggs that the female body ‘recruits’ each month for ovulation ends with just one of those eggs actually ovulating.

So again, to be efficient, doctors want to get more than just one egg from a woman’s recruited batch of eggs. And to get them, they need to retrieve them via a procedure. So how many eggs do they retrieve?

How is mini-stim IVF different?

This is where traditional IVF and mini-stim IVF diverge – in traditional IVF, women take injectable medications multiple times a day for ten days in order to grow and mature all of the eggs in their recruited batch at once so that doctors can remove all of those eggs on retrieval day.

With mini-stim, women also take medications for about ten days, but the medications are mostly oral, with some injectables, so that only a handful of eggs grow and mature from the batch. Then, on retrieval day, only that handful of eggs is retrieved. The logic is simple – the more medication, the more eggs will mature; the less medication, the fewer eggs will mature.

If you’re wondering why the goal of mini-stim is not to get as many eggs as possible, it’s because some women benefit from a gentler, less aggressive type of treatment.

This includes women with:

• low or Diminished Ovarian Reserve (or those who don’t have a lot of eggs in their ovaries)
• women who are over 40 years old (again because of their low ovarian reserve) or women with PCOS. Other women who may benefit from mini-stim are women who are sensitive to hormonal fluctuations (women with anxiety, for example) or women who just want a more relaxed, natural alternative to traditional IVF that involves fewer needles, ultrasounds, and blood work appointments.

Now that that’s out of the way, let’s get into the details about how many eggs are retrieved during mini-stim IVF.

So how many eggs are retrieved with mini-stim IVF?

We should state here that the number of eggs retrieved in mini-stim IVF (and traditional IVF for that matter!) vary from woman to woman, cycle to cycle, clinic to clinic, and protocol to protocol (remember medical protocol changes can affect egg count results).

Egg counts are impossible to accurately predict, and any attempt to estimate results, such as the estimates below, are just that – estimates that should be taken with a grain of salt. Egg retrieval numbers are very personal – so don’t worry if your count is not listed below. In the world of fertility treatment results, the range of ‘normal’ is very wide.

OK, let’s get estimating.

Women under 30 years old with no reproductive issues

 Young women with a well-functioning reproductive system may net as many as eight to nine eggs after one mini-stim IVF cycle. While they will have many more eggs than this in their ovaries at the start of their cycle, the lower dose mini-stim protocol will only grow some of those eggs – namely, the best quality eggs that are most sensitive to the medication.

Since a woman’s egg reserve is highest in her mid-to-late 20’s, a woman pursuing mini-stim at this time will net more eggs than she would in her mid-30s.

Women with PCOS

Although you may have thought that young women would produce the highest number of eggs through mini-stim, the category of women who usually produce the most are those with PCOS, because they have the most to start with. Women with PCOS could produce more than ten eggs in one mini-stim cycle.

PCOS (Polycystic Ovarian Syndrome) is a hormonal condition marked by having many eggs, but rarely if ever ovulating them, leading to infertility. Whereas a healthy woman’s body will recruit a batch of eggs every month to compete for ovulation, and a single egg will grow big enough to ovulate, the body of a woman with PCOS will also recruit that batch of eggs, but none will grow big enough to ovulate. With the help of additional hormones, however, the eggs in her follicles will grow and mature, so when they are retrieved they will be ready to be paired with sperm.

Women with low ovarian reserve

Whether you call it a low ovarian reserve or a Diminished Ovarian Reserve (DOR), the condition means you don’t have very many eggs – and by extension, very many good quality eggs – in your ovaries.

Women with DOR are often young but have a smaller egg pool than they should for their age. It is also common for older women to have low ovarian reserve due to their age. Women with these conditions usually get two or three eggs in one mini-IVF cycle. And while that number seems low, many women with these conditions do get pregnant after mini-stim treatment because those few eggs are good quality eggs and their bodies are not overburdened with a more aggressive protocol.

Women in their mid-to-late 30s

 This is probably the most common demographic of women pursuing mini-stim IVF, and these women often walk away with between five and eight eggs after a cycle.

What if I need to retrieve more eggs?

Great question. The reason both traditional and mini-stim IVF retrieve more than a single egg is because both the body and medicine are imperfect, and the more embryos a patient or couple have, the better.

For example, before a baby is born from any type of IVF, the following has to happen, in this order. The eggs retrieved have to be mature; they have to fertilize with sperm; they have to grow big enough to become a ‘blastocyst’ on day five or six of growth; they have to come back from genetic testing as normal embryos instead of abnormal embryos; and following transfer, that embryo has to implant successfully, and for the long term, inside a woman’s uterus.

Unfortunately, each of these steps can result in failure, which is why in traditional IVF, each cycle is aimed at getting the most number of eggs so women have several backup eggs to make embryos with. While this backup strategy is also employed in mini-stim, there are less backup eggs because there are fewer retrieved eggs.

The good news is that these few eggs that are retrieved in mini-stim tend to be good quality eggs. And, because mini-stim is affordable and gentle, women usually have no problem doing two or three cycles in order to ‘bank’ more eggs/embryos.

Can I know how many eggs I will retrieve before starting treatment?

The number of eggs retrieved in any given mini-stim cycle will depend on the woman, the protocol, and the particular cycle. If you’re curious about how many eggs you might make, make an appointment with your clinic and have your initial blood work and ultrasound done. Your doctor should be able to give you a good estimate of how many eggs you’ll walk away with after your first cycle, and you can think about whether mini-stim makes sense to you.