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Ovarian stimulation protocols for IVF: is more better than less?
Michael M Alper1, Bart C Fauser2
1Boston IVF, 130 2nd Avenue, Waltham, MA 02451, USA.
Reproductive Biomedicine Online
|February 8, 2017
Summary
Mild ovarian stimulation for IVF may offer comparable cumulative pregnancy rates to conventional methods, with fewer side effects. Choosing the best protocol requires individual patient assessment, as both approaches have unique benefits and challenges.
Area of Science:
- Reproductive Endocrinology
- In Vitro Fertilization (IVF)
Background:
- Conventional IVF ovarian stimulation aims for maximum oocyte yield but carries risks like OHSS, discomfort, and high costs.
- Mild stimulation protocols use lower gonadotropin doses or shorter durations, targeting fewer oocytes (under eight).
Purpose of the Study:
- To compare the advantages and disadvantages of conventional ('more is better') versus mild ('less is best') ovarian stimulation protocols for IVF.
- To discuss patient-specific factors influencing protocol selection.
Main Methods:
- Review and comparison of existing data on conventional and mild ovarian stimulation protocols.
- Discussion based on a live debate at the American Society for Reproductive Medicine 2015 Annual Meeting.
Main Results:
- Mild stimulation has lower per-cycle pregnancy rates (fresh embryo transfer) but comparable cumulative rates to conventional stimulation.
- Data on embryo quality effects remain conflicting between mild and conventional protocols.
Conclusions:
- Both conventional and mild ovarian stimulation protocols have distinct benefits and challenges.
- Individual patient needs are paramount in selecting the optimal IVF stimulation strategy.
- Further prospective studies are required to compare diverse outcomes of both stimulation approaches.
