In 1978, in vitro fertilization (IVF) revolutionized the world of infertility. Since then, the procedure has helped thousands of people have healthy, happy pregnancies. IVF remains the gold standard in infertility care when other treatments fail or when a couple has certain fertility issues, such as low motility or unexplained infertility.
Yet for many couples, the cost of IVF and the use of injectable hormones remain a barrier to accessing this highly successful treatment protocol.
Minimal stimulation IVF (MSIVF) -- sometimes called mini IVF, soft IVF, or micro IVF -- offers an alternative that is both cost efficient and potentially less stressful. For many couples, it is an excellent option.
What is Minimal Stimulation IVF?
With traditional IVF, the woman takes a number of drugs designed to stimulate egg production. For most women, it’s necessary to at the very least take hormonal drugs to suppress ovulation. Then, the woman takes another set of hormonal drugs to encourage the body to develop multiple eggs.
When a woman produces multiple eggs at once, this increases the odds of at least one egg being successfully fertilized and then developing into a healthy embryo that then becomes a healthy baby.
These drugs are highly effective. For women under 35, the odds of success with an IVF cycle are at least 40%. Even older women experience high success rates of 25% or greater. So there’s good reason to use these drugs. However, fertility drugs increase the time and expense associated with IVF.
The drawbacks of fertility drugs include:
- Having to make multiple visits to the fertility clinic. That means more expense, more time taken off of work, and more inconvenience.
- Having to give yourself injections at home. Many couples find this emotionally and physically exhausting.
- Paying for expensive fertility drugs. Most couples pay for fertility treatment out of pocket, and fertility drugs are a major factor driving the expense of IVF.
- Side effects associated with fertility drugs. Fertility drugs are safe, especially when used appropriately under the watchful eye of a skilled doctor. However, many women experience mild side effects such as mood swings or weight gain. This can feel frustrating, especially to couples who already feel demoralized by the pain and frustrations inherent to infertility.
- A risk of ovarian hyperstimulation. This can cause painful, swollen ovaries. In very rare cases, it may trigger more severe complications.
- Multiple pregnancies. Multiple pregnancies are much more common with IVF. This can increase the risk and difficulty of pregnancy, and multiples most costs associated with having children. Some couples cannot afford multiple children, or worry about their ability to appropriately care for multiple newborns.
Minimal stimulation IVF uses few or no fertility drugs. In most cases, a woman will use a drug to trigger ovulation, but will not need to take injectable drugs or attend multiple medical appointments.
What is the Procedure for Minimal Stimulation IVF?
Minimal stimulation IVF works the same as traditional IVF, with an important exception: a woman does not need to use injectable fertility drugs.
Every woman is different, and good fertility specialists make customized recommendations based on your health, fertility goals, and other factors.
In general, you can expect the following as part of minimal stimulation IVF:
- An initial consult and diagnostic workup to test for common fertility concerns. In many cases, a doctor may recommend less aggressive treatment first, such as using ovulation drugs to induce ovulation.
- A consultation about IVF. A doctor will discuss with you whether you are a good candidate for IVF. In some cases the provider may make recommendations about health or lifestyle changes that can increase the efficacy of IVF. For example, if you smoke you will need to quit. If you are obese, losing weight may reduce the risk of pregnancy.
- Drugs to induce ovulation. A woman may take clomid or other drugs to induce ovulation. In some cases, she might need to take other medication.
- Monitoring of a woman’s cycle and ovulation. A doctor will schedule an appointment to ensure a woman ovulates. If a woman has a history of ovulatory dysfunction or irregular cycles, a provider may want her to complete a month on an ovulation induction drug before trying IVF. This ensures that the drug works and that she ovulates on time.
- Retrieval of the egg. A doctor will also need sperm to fertilize the egg, so if you are using your partner’s sperm,your partner will provide semen in a cup.
- Fertilization of the egg. A doctor fertilizes the egg with sperm inside a lab. Then you’ll wait several days for the egg to begin growing into an embryo.
- Implantation. Implantation is the medical beginning of pregnancy, when an embryo burrows inside the wall of the uterus. During IVF, a doctor implants the developing embryo back into the uterus. Ideally, the embryo then implants in the uterine lining.
- Other hormones, if necessary. Some women do not produce enough progesterone or other hormones to sustain a healthy early pregnancy. If blood tests reveal that you have a hormone imbalance, you may need to take additional hormones following implantation.
- Pregnancy test. A few days later, you will take a pregnancy test. If it is positive, your provider will continue monitoring your pregnancy and you will see an OB or midwife toward the end of the first trimester. If the test is negative, then you and your provider will discuss next steps.
Benefits of Minimal Stimulation IVF
The benefits of minimal stimulation IVF include:
- Less reliance on hormones. That means fewer side effects.
- Lower costs. With fewer drugs to take and fewer clinic visits, the couple will have to pay less, and can therefore potentially try multiple IVF cycles.
- Few or no injections. For many women, the stress and pain of regular injections makes IVF less attractive.
- No risk of ovarian hyperstimulation. For women with a previous history of this symptom, or at risk of developing it, this can make IVF safe and attainable.
Minimal stimulation IVF is less effective than traditional IVF, but remains highly effective, especially when compared to other infertility treatments.
Does Minimal Stimulation IVF Work?
Minimal stimulation IVF is less effective than traditional IVF. That’s because a woman will only produce one egg, and the internal processes leading up to ovulation will be less tightly controlled. Nevertheless, well-monitored minimal stimulation IVF can be extremely effective. A 2016 study found that the procedure was especially effective for women under the age of 40, and that minimal stimulation IVF completely eliminated the risk of ovarian hyperstimulation.
Although minimal stimulation IVF is less effective, it’s a great option for people who cannot afford traditional IVF, those who want to avoid fertility drugs, and couples who are concerned about the prospect of multiple pregnancies. Because it is less expensive, it is also more affordable to do multiple IVF cycles if the first cycle fails.
Who is a Good Candidate for Minimal Stimulation IVF?
Not everyone is a good candidate for IVF. To be a good candidate, you must:
- Be in reasonably good health. Your doctor may recommend treating any chronic health conditions, quitting smoking, or losing weight first.
- Have a healthy uterus. Some women with endometriosis or other uterine conditions are not good candidates for IVF.
- Be capable of carrying a pregnancy.
- Have healthy eggs.
- Have a partner with healthy sperm, or use donor sperm.
- Have a condition that IVF can treat, such as unexplained infertility, infrequent ovulation, PCOS, or low sperm motility.
- Be able to keep clinic appointments, and be able to safely use any medications your doctor recommends. Women with certain heart conditions, for example, may not be able to safely use certain hormonal treatments.
Talk to your doctor about your complete medical history. In most cases, you may also want to try less aggressive treatment modalities first.
When to Seek Treatment for Infertility
Infertility strikes at the very core of what makes us human--the desire to be a parent and to continue the next generation. So it can also trigger a wide variety of emotions, including frustration, anger, depression, self-loathing, and more.
Many couples who struggle with infertility report relationship troubles. Some experience anxiety or depression. Most say that fertility issues take over much of their life, and often distract them from enjoying other pursuits, such as travel or time with friends.
No matter how long you have tried or why you are infertile, there is hope. But you need the right care and the right support. The Center of Reproductive Medicine has helped thousands of people just like you. We offer compassionate, comprehensive care. Our team is at the forefront of fertility medicine. We don’t just know the standards for care; in many cases, we’ve helped to develop them. So turn to an expert and shorten the timeline to pregnancy.
When should you seek help?
We recommend seeing an infertility specialist if:
- The woman is under 35 and you have tried for longer than a year to get pregnant, or the woman is over 35 and you have tried for longer than 6 months.
- The woman has had two or more miscarriages in a row.
- Either partner has a condition that can diminish fertility, such as a varicocele or polycystic ovary syndrome (PCOS).
- The woman has irregular periods, or has reason to believe she is not ovulating once a month.
- Either partner has a chronic health condition.
Some people also opt to undergo fertility testing before they begin trying to get pregnant. This can offer significant peace of mind, and help you avoid wasting time and effort if there is a problem.
We’re here and ready to help. To explore your fertility options, give us a call today. Our warm and welcoming team is here for you.