Should mild stimulation be the order of the day?
- PMID: 24672159
- PMCID: PMC3963303
- DOI: 10.4103/0974-1208.126282
Should mild stimulation be the order of the day?
Abstract
Mild stimulation protocols aim to reduce the physical, financial and emotional burden associated with the conventional IVF protocol without compromising the pregnancy rate. Such protocols help to decrease the complications and the discomfort related to the prolonged administration of agonist and large doses of gonadotrophins, by limiting the number of oocytes recruited to no more than eight. The per cycle pregnancy rates are lower though the cumulative pregnancy rate in a year is equivalent. This CPR comes by going through earlier repeat cycles. Whether this reduces the physical, emotional or financial burden remains a matter of debate. There is need to standardize these protocol and do more trials to compare the two effectively. Till such time there is a clear benefit above the conventional protocol it will not be the protocol of choice with most physicians.
Keywords: Gonadotrophins; in vitro fertilization; infertility; mild stimulation protocol.
Conflict of interest statement
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References
-
- Griesinger G, Kolibianakis EM, Venetis C, Diedrich K, Tarlatzis B. Oral contraceptive pretreatment significantly reduces ongoing pregnancy likelihood in gonadotropin-releasing hormone antagonist cycles: An updated meta-analysis. Fertil Steril. 2010;94:2382–4. - PubMed
-
- Edwards RG, Lobo R, Bouchard P. Time to revolutionize ovarian stimulation. Hum Reprod. 1996;11:917–9. - PubMed
-
- Nargund G, Fauser BC, Macklon NS, Ombelet W, Nygren K, Frydman R, et al. The ISMAAR proposal on terminology for ovarian stimulation for IVF. Hum Reprod. 2007;22:2801–4. - PubMed
-
- Macklon NS, Stouffer RL, Giudice LC, Fauser BC. The science behind 25 years of ovarian stimulation for in vitro fertilization. Endocr Rev. 2006;27:170–207. - PubMed
-
- Verberg MF, Eijkemans MJ, Macklon NS, Heijnen EM, Baart EB, Hohmann FP, et al. The clinical significance of the retrieval of a low number of oocytes following mild ovarian stimulation for IVF: A meta-analysis. Hum Reprod Update. 2009;15:5–12. - PubMed
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