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Abstract
Background: Over the last decade, the laboratory procedures in artificial reproduction have improved, thus fewer eggs are necessary. Therefore mild stimulations have been introduced to reduce the risk for the patient and patient drop-outs in treatment. The present study was designed to evaluate the efficacy of low stimulation with Tamoxifen and FSH in a routine IVF clinic. Material and methods: A total of 2,709 regular short antagonist IVF cycles were compared to 170 Tamoxifen low stimulation IVF cycles. All patients were recruited in the same time period and allocated to the different treatments on their own request. Results: No differences in age and number of previous cycles were found in between the groups. The clinical pregnancy rate was found to be significantly lower in the Tamoxifen treated group (20% vs. 26%), however we did not find any significant pregnancy rate following transfer (31% Tamoxifen group vs. 28% in conventional IVF). We found lower numbers of visits, lower costs for medication, less side effects and better acceptance for treatment in the Tamoxifen group. Conclusion: Although we found a lower pregnancy rate per started cycle, the pregnancy rate per transfer was equal and better accepted by the patients.
Highlights
Over the last decade, the laboratory procedures in artificial reproduction have improved, fewer eggs are necessary
The clinical pregnancy rate was found to be significantly lower in the Tamoxifen treated group (20% vs. 26%), we did not find any significant pregnancy rate following transfer (31% Tamoxifen group vs. 28% in conventional IVF)
It has been demonstrated that the health of off-springs from mild stimulation is comparable to conventional IVF [5]
Summary
The laboratory procedures in artificial reproduction have improved, fewer eggs are necessary. Mild stimulations have been introduced to reduce the risk for the patient and patient drop-outs in treatment. The present study was designed to evaluate the efficacy of low stimulation with Tamoxifen and FSH in a routine IVF clinic. Low stimulation has been associated with lower pregnancy rate or efficacy in ART without proper documentation. With the new and better laboratory technologies [1] the number of eggs retrieved for achieving a pregnancy can be reduced, the need for ovarian stimulation can be questioned. The wide spread use of single embryo transfer makes is unnecessary to harvest more than a few eggs in an IVF cycle [4]. It has been demonstrated that the health of off-springs from mild stimulation is comparable to conventional IVF [5]. The potential negative effect of Clomiphene on the endometrium might be overcome by transferring the embryos in later cycles using vitrification of the embryos [6]
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