Hopes and facts about mild ovarian stimulation

Area of Science:

• Reproductive Endocrinology
• In Vitro Fertilization (IVF)

Background:

• Conventional IVF protocols often involve complex, lengthy, and expensive stimulation regimens.
• Long-term gonadotrophin-releasing hormone agonist protocols, widely used since the mid-nineties, carry risks and complications.
• There is a growing need for more accessible and less demanding IVF treatments.

Purpose of the Study:

• To evaluate the efficacy and cost-effectiveness of mild stimulation protocols in IVF.
• To compare outcomes of mild stimulation with conventional stimulation protocols.
• To explore the potential of natural cycle IVF as an alternative.

Main Methods:

• Comparison of mild stimulation protocols versus conventional stimulation protocols.
• Analysis of stimulation duration, gonadotrophin dosage, and oocyte yield.
• Assessment of embryo quality, euploidy rates, and pregnancy rates per embryo transfer.

Main Results:

• Mild stimulation protocols reduce stimulation days, gonadotrophin usage, and oocyte retrieval numbers.
• A higher proportion of high-quality and euploid embryos may be observed with mild stimulation.
• Pregnancy rates per embryo transfer are comparable, with improved patient tolerability and cost-effectiveness.

Conclusions:

• Mild stimulation protocols present a clinically and cost-effective approach to IVF.
• Natural cycle IVF shows promise, particularly for normo- and poor responders, but requires further validation.
• Prospective randomized studies are essential to definitively compare cumulative pregnancy rates between mild and conventional protocols.