by Dr Agilan Arjunan , Fertility Specialist & Gynaecologist, KL Fertility Centre ( Malaysia)
Main take home point of this article :
As a fertility doctor, I suggest a young couple who needs an IVF to discuss about IVF protocol without or with very minimal injections. In my practice , I see a good success rate if the couples are selected properly.
IVF is associated with daily injections of hormones. These hormones are needed to stimulate grow of multiple follicles ( eggs) and to create more than one embryo per IVF cycle.
This approach is commonplace because cumulative pregnancy rate is higher when up to 10-14 eggs are collected per IVF cycle. While a standard IVF protocol may be good to achieve a higher pregnancy rate, it also has its own disadvantages.
A standard IVF protocol carries a risk of ovarian hyperstimulation (OHSS) , longer days off work , especially after egg collection procedure and a higher total IVF cost .
Probably it’s time to look at a more gentle , perhaps an IVF without or with very minimal injections.
A recent analysis from Japan have looked into the success rate of an IVF protocol with Clomifene Citrate. For a young couple ( female partner less than 34 yrs old) , the cumulative pregnancy rate after three IVF cycles is about 70% .
In an IVF protocol with oral tablets, the women makes only a few eggs per stimulation . Hence, she may need to repeat the IVF cycle to make more embryos. In a younger couple, generally few eggs are enough to make a good quality embryo. Furthermore , it is much more patient friendly.
On the aspect of cost, the cost of an IVF cycle can reduce significantly and thus a couple be able to do more than one stimulation cycle .
In my practice, I normally suggest a minimal stimulation IVF for a young couple, provided they fulfil the selection criteria. I see a very good success rate with this approach while reducing the overall IVF cost.
In conclusion, younger couples who need an IVF should discuss about minimal stimulation IVF with their doctor.
Source : https://link.springer.com/article/10.1007/s10815-019-01662-z?wt_mc=alerts.TOCjournals&utm_source=toc&utm_medium=email&utm_campaign=toc_10815_37_2