Mini IVF Protocol – Overview
Mini IVF is also called Miniature IVF and is a form of IVF which uses low stimulation (gonadotropin) medical protocol. This is a type of in-vitro fertilization technique that is also known as Micro, Low Stim/Stimulation or natural IVF.
There is no need to remember all these terms as they all refer to the same IVF treatment protocol.
By using fewer medications fertility specialists can produce a small number of high-quality eggs and at the same time ensure to reduce the risk of hyper-stimulation to practically zero.
This is often done by using Lupron as a trigger. Some reports show that these fewer eggs are of a higher quality than the eggs produced through a conventional IVF procedure however there is a lack of sufficient proof to back this theory.
Despite this, mini IVF is an ideal choice of fertility treatment for many couples.
Why Should You Undergo Mini IVF?
There are various favorable reasons to choose a mini IVF to achieve a successful pregnancy, such as:
Low/Diminished Ovarian Reserve
Women with diminished ovarian reserve (DOR) may not be too successful using stimulating medications. So, taking fewer medications does not mean having fewer eggs. As you would not be producing more eggs by taking more medications, there is no point in doing so.
In such cases, a mini IVF generally means almost a similar number of eggs, less cost and a reduced risk of hyper-stimulation.
High risk of Ovarian Hyper-Stimulation
Those patients at risk of the ovarian hyper-stimulation syndrome (OHSS), such as PCOS (Polycystic Ovarian Syndrome) are usually well-suited and ideal candidates for a mini IVF as by decreasing the number of stimulating medications you can effectively lower the risk of hyper-stimulating the ovaries and can still produce sufficient quantities of eggs.
As mini IVF requires using fewer medications for stimulating the ovaries, the overall cost of this procedure is substantially less for a single cycle. The reason is that medications take up the bulk of the total cost of an IVF treatment.
However, you should understand that taking fewer medications may also result in fewer embryos being made.
This means that you may have to undergo a more costly IVF procedure instead of using the remaining frozen embryos for an affordable FET. This may make the mini IVF more expensive in the long run.
Compatible and Comfortable
Some patients are of the opinion that the mini IVF protocol is more in line with their philosophical beliefs and faith as it lowers the risk of hyper-stimulation and also reduces the risk of having a large number of remaining embryos after achieving clinical pregnancy successfully.
Though there are many viable options to deal with the remaining embryos, such as storing them for use in the future, discarding them or choosing to donate the embryo to another deserving couple. Most patients prefer not having to make this choice, though for personal reasons.
Mini IVF is quite suitable for a wide variety of infertile couples and is highly considered by most patients after failing to achieve pregnancy with conventional IVF methods.
Patients who have undergone IUI (intra-uterine insemination) or have male or female infertility testing that proves those lesser treatment methods are not medically advisable.
What is the Mini IVF Protocol?
Just like there is no standard name for the mini IVF, there is no standard protocol to follow for the low-stimulation or mini-in-vitro fertilization cycle. In general, mini IVF combines the use of oral medication and injectable FSH medication.
A traditional IVF cycle usually uses only one injectable medication during the stimulation phase of an IVF cycle, it uses a substantially higher dose than mini IVF.
A mini IVF treatment at reputed fertility clinics usually involves using oral medication for around 5 days and a much lower dose of injectable medications for 10 days.
This is a step-by-step breakdown of the usual procedure followed for a mini IVF:
Step 1 – Ovarian Stimulation
For a mini-IVF cycle, patients are advised to take hormone-based medications during ovarian stimulation which ensures that the ovaries develop a small number of high-quality eggs, as opposed to a single egg that is produced each month.
Most patients tend to take oral medications for 5 days and follow them with 10 days of injectable medication doses. The stimulation phase in a mini IVF treatment usually begins on the 2nd to 4th day of the woman’s menstrual cycle.
Step 2 – Egg Retrieval and Sperm Collection
The egg retrieval procedure is an extremely crucial part of a mini IVF treatment. It is a minor outpatient procedure meant to collect the fully-developed eggs from the patient’s ovaries. This procedure is usually performed 35 hours after the “trigger” medication is administered.
During the egg retrieval process, the physician will use a small syringe needle to suck out the eggs from the follicles in the ovaries.
The next phase of this step is the sperm collection procedure. This is done through a normal ejaculation into a cup method. This phase is performed on the morning of the egg retrieval, processed, frozen and stored for use in the next phase.
Once the sperm is processed, the remaining motile concentrated sperm will be retrieved and taken to the embryology lab for effective fertilization.
Step 3 – Fertilization and Embryo Development
Just like conventional IVF, the eggs can be fertilized using one of two basic techniques, in a mini IVF too. Conventional fertilization requires placing the sperm in a petri dish and letting fertilization happen by the natural sperm propulsion and penetration into the egg.
On the other hand, ICSI fertilization occurs when an individual sperm is injected directly into an egg, using a long, fine needle.
Once the egg is fertilized, the embryo that develops out of it will grow in a nourishing media that is a replica of the internal environment of the fallopian tube for 2 to 5 days.
Step 4 – Embryo Transfer
Once the embryo starts developing, a couple of embryos may be transferred back into the patient’s uterus with the hope of successful implantation and development within the uterus. This step is quite simple, similar to an IUI with the difference being that this technique requires transferring embryos and not sperm.
The developing embryo is carefully loaded into a catheter, which is gently inserted past the cervix and off-loaded into the uterus. Once the embryo takes hold, pregnancy is initiated.
The cost of mini IVF is usually quoted as being much more affordable than standard IVF. It is true that the total treatment cost for a single mini IVF is more affordable in comparison to the cost of conventional IVF treatments.
The cost of a mini IVF procedure at fertility clinics is usually the same, the pharmacy you choose to buy the stimulant medication and the reduced medication protocol are factors that determine the specific total cost of a mini IVF.
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