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Mini IVF Is Not Fast, Less Expensive Route to Baby, Study
by Leigh Ann Woodruff, April 16, 2012
In today's economic environment, for a couple who needs in vitro fertilization, the cost of traditional IVF can be daunting, and some fertility patients may explore mini IVF as a lower cost alternative. However, a new study published in Reproductive Biomedicine Online finds that the success rates are low, and, therefore, the "take-home baby" cost can equal or surpass the cost of regular IVF.
What Is Mini IVF?
Mini-IVF is also known as minimal stimulation IVF, low-intensity IVF and micro-IVF. The different between mini-IVF and conventional IVF is in the amount of hormonal stimulation, which is milder in mini-IVF. In conventional IVF, the goal is to stimulate the ovaries to produce multiple eggs for retrieval. With mini-IVF, oral fertility drugs such as Clomid may be used along with a milder injectable in order to produce only a few eggs.
The idea behind mini-IVF is that pregnancy success can be achieved through milder stimulation, which can reduce the patient's exposure to fertility drugs, as well as money spent on fertility treatment. However, while the concept sounds wonderful, "none of the claims made for mini or low-stimulation IVF have ever been proven with a comparative study where patients were randomized to regular IVF or a form of mini-IVF and outcomes compared," says Norbert Gleicher, M.D., medical director of the Center for Human Resources (CHR) in New York.
The Study on Mini IVF
Dr. Gleicher and the researchers at CHR set out to evaluate whether mini IVF was more economical and patient-friendly. To do this, they matched patients in low-stimulation IVF cycles to patients of the same age and comparable ovarian reserve who were undergoing traditional IVF cycles. All of the patients were under 38 years old. "It is not a perfect prospective randomized study, but it is solid," Dr. Gleicher says.
The researchers found that patients in low intensity cycles produced significantly fewer eggs and embryos, and and they had much lower pregnancy rates. The pregnancy success rate was 50 percent for traditional IVF and only 21.4 percent for mini IVF. "It was a surprise that even in the initial fresh IVF cycle, the rates with regular IVF were significantly higher than mini IVF," Dr. Gleicher says. "We had expected the cumulative pregnancy rates would be better in traditional IVF because the patient would have more frozen embryos."
In addition, they found that while the per cycle cost of mini IVF was lower when compared to traditional IVF, "when we analyzed cost not on a per IVF cycle basis but on having a baby at home, there were no significant differences," Dr. Gleicher says. The overall costs to achieve a successful pregnancy were similar because the lower pregnancy rates associated with mini IVF meant that mini IVF patients, on average, needed more cycles to have a take-home baby.
Considering Mini IVF?
When considering different fertility treatments, do your research and weigh the pros and cons of each option carefully.
"Mini IVF as it is widely practiced today appears to reduce a young patient's pregnancy chances without a compensatory benefit of any kind," says Dr. Gleicher. “When patients started asking for low stimulation IVF at our fertility clinic, we, like many other IVF centers, decided to offer the procedure. We have been offering under experimental consent only to younger women with proven normal ovarian reserve. We explained to our patients that mini IVF should still be considered experimental, since no data existed that compared this method of IVF to standard IVF.”
Dr. Gleicher warns older patients in particular to think carefully before they choose this option. "We do not offer mini IVF to older women and strongly recommend against its use in this patient population who has limited time to conceive and whose ovarian reserve is declining," he says.