In other words, Minimal IVF is a useful method that can help women get pregnant with fewer medication-associated risks at a lower cost. In a Natural IVF cycle no ovarian stimulation is performed no medications are taken , and the typical yield is eggs which may or may not result in an embryo after fertilization. Minimal IVF stimulation will yield, on average, eggs and can produce embryos, increasing the chances for at least one healthy embryo for transplantation.
Traditional IVF uses a high dose of gonadotropins to assure that there are as many eggs retrieved as possible. Minimal IVF protocols differ from clinic to clinic. Any patient interested in this technique should talk to their clinic about their experience with Minimal IVF and determine what their protocols are for stimulation and what their particular success rate is. Minimal IVF protocols may begin with a natural cycle or after short course of birth control pills oral contraceptive pills or OCPs or a course of estrogen preparation to regulate the cycle.
This is then followed by ovarian stimulation with oral or injectable ovulation induction agents. For patients who are older than 35 years of age , some protocols will forgo use of OCPs and begin stimulation of the ovaries after suppression of follicle recruitment by using estrogen in the luteal phase period after ovulation in a natural cycle or on day of the natural menstrual cycle..
Monitoring is primarily by ultrasound exams with a limited number of blood tests to monitor the hormone levels. In other words, Mini-IVF is a useful method that can be used to help women get pregnant with minimal risks and low cost. As such, patients undergoing Mini IVF may achieve the following benefits:. Mini IVF protocols may differ slightly from clinic to clinic but share a common goal: a gentle mild stimulation of the ovaries for the purpose of obtaining a small number of high-quality eggs and embryos.
In patients older than 35 years of age, some protocols will forgo the use of OCPs and begin stimulation of the ovaries on day of the menstrual cycle.
Many Mini IVF protocols will involve the addition of low doses of injectable gonadotropins to orally ingested ovulation induction agents often referred to as Micro IVF , while other protocols rely on low doses of gonadotropins only for ovarian stimulation. Monitoring is primarily by ultrasound exams with a minimal number of blood tests. The egg retrieval procedure is identical to that done in traditional IVF, except that some patients will prefer to avoid intravenous sedation anesthesia since only a small number of eggs are harvested, and choose to undergo the procedure with oral analgesia pain medications only.
Eggs are fertilized in the IVF lab with either standard insemination mixing of sperm with eggs when no male factor exists or with intracytoplasmic sperm injection ICSI in cases where male factor infertility exists.
Embryos may be transferred back into the uterus when they are 3, 4, 5 or 6 days old. The main objectives are to create good quality embryos and to make the procedure as simple as possible for the patient. The entire process takes place over about days. It is now known that the extremely high stimulation dose in conventional IVF seems to lead to a deterioration of the implantation rate after embryo transfer.
Now, one might think that this problem would therefore be solved by the restrained stimulation. This means that on the one hand, with less medication, you get the same number of good eggs, but at the same time -possibly- the pregnancy rate is reduced due to an inferior mucosa.
The solution to this problem is the cryopreservation of the oocytes or the fertilized oocytes. Therefore, it is recommended to cultivate the retrieved oocytes, freeze the embryos, and transfer them only in the next cycle cryo transfer.
This procedure is not recommended as initial therapy.
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