Mild ovarian stimulation with clomiphene citrate launch is a realistic option for in vitro fertilization

Abstract

To validate the use of clomiphene citrate in IVF when mild stimulation approaches are chosen to reduce patient discomfort, risk, and cost. Prospective cohort study. Private IVF clinic. A total of 163 patients undergoing IVF and with a good prognosis (defined as ≤38 years old with normal ovarian reserve and normovulatory cycles, body mass index <29 kg/m(2), no previous assisted reproductive technology cycles, no severe endometriosis, no history of recurrent miscarriage, no endocrine/autoimmune diseases, and no surgical semen extraction). Mild stimulation using a fixed protocol of clomiphene citrate (100 mg/d from cycle days 3 to 7) in combination with low doses of gonadotropins (150 IU of recombinant FSH on cycle days 5, 7, and 9) and GnRH antagonist. The cumulative delivery rate per patient after three fresh and/or frozen embryo transfers and time to pregnancy. No dropouts were observed. The cumulative delivery rate was 70%, and the mean time to pregnancy was 2.4 months. Mild stimulation using clomiphene citrate in combination with low doses of gonadotropins can be considered a realistic option for good-prognosis patients undergoing IVF.