Mini IVF Protocol – Overview
Mini IVF, also known as minimal stimulation IVF, is a form of IVF that uses a low-dose medication protocol. This type of in-vitro fertilization technique 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 a reduction in the risk of hyper-stimulation to practically zero.
This can involve using a different medication for the trigger shot, not necessarily Lupron, which is more commonly used in traditional IVF protocols. Some reports show that these fewer eggs are of a higher quality than those produced through a conventional IVF procedure; however, there is a lack of sufficient proof to back this theory.
However, the suitability of mini IVF depends on individual circumstances and should be determined by a fertility specialist.
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 have a lower response to high doses of stimulating medications. Taking fewer medications usually results in the production of fewer eggs. As you would not be producing more eggs by taking more medications, there is no point.
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.
Potentially Less Costly Initially
As mini IVF requires using fewer medications to stimulate the ovaries, this procedure’s overall cost is substantially less for a single cycle. The reason is that medications take up the bulk of the total cost of an IVF treatment.
It is important to note that using fewer medications often leads to the creation of fewer embryos.
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 think 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.
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 making this choice, though for personal reasons.
Other 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 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 often uses a combination of injectable medications at higher doses than those used in mini IVF.
A mini IVF protocol generally includes a combination of oral and injectable medications, but the specific duration and dosage can vary based on the clinic and individual patient needs.
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 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 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 egg retrieval, and it is 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, eggs can be fertilized using one of two basic techniques in a mini IVF. Conventional fertilization requires placing the sperm in a petri dish and letting fertilization happen by 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 replicating the fallopian tube’s internal environment 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 in the hope of successful implantation and development. This step is quite simple, similar to an IUI, with the difference being that this technique requires transferring embryos rather than 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.
Conclusion
The initial cost of mini IVF can be lower than standard IVF, but overall expenses may vary depending on the number of cycles required and additional treatments. The total treatment cost for a single mini IVF is more affordable than conventional IVF treatments.
The cost of a mini IVF procedure at fertility clinics is usually the same; the pharmacy where you choose to buy the stimulant medication and the reduced medication protocol determine the total cost of a mini IVF.
IVF Grants in the U.S.
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