Optimal pregnancy outcome in a minimal-stimulation in vitro fertilization program

Area of Science:

• Reproductive Medicine
• Infertility Treatment
• Assisted Reproductive Technologies

Background:

• Standard in vitro fertilization (IVF) can be prohibitively expensive for many infertile patients.
• Minimal ovarian stimulation (MOS) protocols aim to reduce medication costs and side effects.
• Determining the optimal level of ovarian stimulation is crucial for achieving successful pregnancy rates in IVF.

Purpose of the Study:

• To evaluate a cost-beneficial approach to IVF using minimal ovarian stimulation.
• To identify the optimal level of ovarian stimulation for acceptable pregnancy rates in IVF.
• To compare outcomes between different phases of minimal stimulation protocols.

Main Methods:

• Retrospective cohort study of 216 patients undergoing "minimal stimulation" IVF from 1994-1998.
• Comparison of early (various MOS protocols) and later (ultrashort flare protocol) phases of the study.
• Analysis of clinical pregnancy rates, multiple gestations, complications, and maternal age.

Main Results:

• The later phase (ultrashort flare) yielded significantly more oocytes (5.9 vs 3.5) and embryos for transfer (2.4 vs 2.0).
• Clinical pregnancy rates per retrieval increased from 16.9% to 36.6% in the later phase.
• Implantation rates improved from 9.3% to 23.3%, with higher success in women under 35.

Conclusions:

• Minimal ovarian stimulation IVF is a cost-effective alternative for infertile patients, especially those under 35 or with adequate oocyte reserve.
• Increased ovarian stimulation, including ultrashort flare protocols, improves IVF outcomes.
• MOS IVF provides a viable option for patients unable to afford standard IVF or concerned about high medication doses.