There are many gimmicks and pitches a Fertility Clinic will try to sell to you to get your business at their facility. In 2010 many clinics started to offer “The Mini IVF.” So what is a Mini IVF? Will it help or benefit you? I hope the information provided will help you to understand and to see if Mini IVF if right for you.
With IVF one of the main objectives is to obtain as many mature eggs as possible as well as safely as possible, in order to increase the chances of having a normal embryo for transfer. Sadly, as we age and as environmental toxins affect our bodies, the quality of eggs produced during each cycle begins to decline as well as the health of eggs. Therefore, making the search for a normal embryo more difficult.
For many women out there with a low egg reserve, the most common strategy for ovarian stimulation uses high doses of stimulating medications. Sadly, for some patients, maximal stimulation doesn’t necessarily result in more eggs at the time of retrieval, due to the number of eggs available for each cycle has already been fixed and is unable to increase. For example, if there are only 2 eggs available in each ovary per cycle, then only 2 mature eggs will be available at the end of a maximally stimulated cycle.
There then comes a point when aggressive stimulation for resistant ovaries is no longer cost effective. So to help the patients whose ovaries only provide 5 or less eggs a cycle, it is suggested that a gentler stimulation protocol that uses the body’s natural reservoir of Follicle Stimulating Hormone (FSH) may be a better alternative.
To help with better understanding this situation lets take a blender, the blender tops out on high speed. Pressing the high speed button aggressively to make the products in the blender will not make it blend faster or crush ice better it will only go as fast as it was made to go. But a better approach would be to cut the fruit smaller, put smaller pieces of ice in the blender so that it will blend faster and better, while saving time and making the blender more efficient.
In 2010, many IVF clinics started to introduce the Mini IVF protocol as an alternate approach to stimulate the resistant ovaries. By combining clomiphene and low dose of injectable FSH, the aim was to collect 1-2 eggs per IVF cycle, with the assumption that this protocol was gentler and result in high quality eggs.
There seemed to be little doubt that the original Mini IVF protocol would lead have a significant savings on the cost of medications, unfortunately it did not improve pregnancy outcomes for women with a low ovarian reserve (6.8% live birth per transfer). It was later found that the embryo quality was not improved by limiting egg production to 1-2 eggs per cycle.
Although this initial protocol is disappointing at most, some Fertility Clinics have chosen to aim to improve results of the original Mini IVF protocol by taking it with a totally different approach. With the belief that nothing can reverse the effects of time on egg’s quality, there is hope to offset this disadvantage by trying to collect as many eggs as the ovaries can provide without the over use of medications.
Therefore, during a Mini IVF cycle, the patient will use a combination of clomiphene and low dose injectable medications, undergo stimulation and monitoring, and then egg retrieval. All matured eggs are injected with sperm (ICSI), and with high hopes the resulting embryos are cryopreserved by vitrification. Once 4 or more embryos are available, the patient can proceed to the Frozen Embryo Transfer (FET) Cycle. Many patients will then require 2 rounds of Mini IVF to accumulate at least 4 embryos for future transfer.
Another added benefit of doing a Mini IVF is that the embryos will be placed into a friendlier uterine environment. This friendlier environment develops during the frozen embryo transfer cycle, because the uterine lining is allowed to grow and mature close to the conditions of a natural cycle, therefore, making it more receptive to the embryos.
Therefore to summarize what we went over in this article, for most patients undergoing IVF treatment, the standard protocols of high stimulation to achieve more eggs can improve the pregnancy rate. However, in women with an extremely low ovarian reserve, a better choice may be to use the gentler stimulation of the Mini IVF cycle to accumulate embryos that can later be transferred to a more receptive uterus during a FET cycle. For these women, less stimulation can mean more embryos for a better chance of success.