Minimal stimulation in vitro fertilization (mini IVF) is an alternate approach to an IVF cycle that consists of a gentle controlled ovarian stimulation that aims to produce a maximum of five to six oocytes. It can also yield as few as two oocytes. This is why it may require more than one round of mini IVF to yield an adequate amount of “good” embryos for an embryo transfer. For women who already have low ovarian reserve, using large amounts of fertility medications does not necessarily increase the number of eggs retrieved per cycle. Additionally, mini IVF offers other advantages such as a reduction in cost and stress with fewer office visits, needle sticks, and sonogram monitoring.
Typically, the mini IVF protocol involves a combination of an oral medication such as Clomid (very inexpensive) with a limited amount of injectable HMGs (human menopausal gonadotropins) such as Menopur. Because lower dosages of fertility medications are prescribed, the patient’s cost per mini IVF cycle is greatly reduced. The final trigger shot used in this IVF protocol can be either a GnRH agonist (like Lupron) or an HCG trigger or a combination of the two. For women who have experienced Ovarian Hyperstimulation Syndrome (OHSS) with a previous IVF attempt, the mini IVF protocol is a safer approach due to the decreased amount of eggs created and potentially the use of the GnRH agonist as the final trigger shot.
The small number of embryos that are created with a mini IVF cycle can be tested using preimplantation genetic screening (PGS) as in other IVF cycles. Even if the patient elects not to use PGS, the embryo(s) would need to be frozen and transferred back to the uterus as part of a frozen embryo transfer (FET) cycle when the uterine lining is more receptive. Clomid has a temporarily negative effect on the uterine lining and we need a “wash out” period so that it responds better to estrogen.
Mini IVF should be considered for those women who:
- Are at increased risk of developing Ovarian Hyperstimulation Syndrome (OHSS), such as PCOS patients
- Have been diagnosed with low ovarian reserve
- Have been diagnosed with cancer and are about to undergo treatment
- Have failed multiple conventional IVF cycles
- Want to reduce their costs of treatment
- Do not want to create excessive embryos due to religious/moral reasons
- Want to reduce their use of injectable medications because of an aversion to needles
At Conceive Fertility Center, we offer packages of mini IVF that include two cycles of IVF which decreases the cost in comparison to two cycles of conventional IVF and, hopefully, yields an adequate amount of embryos for the follow up.