Minimal stimulation (Micro-IVF) achieves similar clinical outcomes in patients under 35 years of age compared to those undergoing conventional controlled ovarian hyperstimulation

Abstract

To evaluate the effect of minimal stimulation cyles (Micro IVF) on clinical outcomes in patients < 35 years of age. A retrospective data analysis from 10/2011 to 12/2012. A total of 264 IVF/ICSI treatment cycles were included in this study. Patients either had Micro IVF protocol (100 mg clomid x 5days, followed by 75IU of gonadotropin x 4-6 days depending on follicle size) or conventional stimulation cycles (ConvIVF) with GnRH antagonist cycles with doses from 150 IU-300 IU gonadotropin per day. The clinical endpoints monitored were the implantation rate (IR), and clinical pregnancy rate per transfer (CPR) and compared statistically using chi square analysis. The average number of oocytes retrieved and fertilized was less with Micro IVF vs ConvIVF cycles (3.48 and 2.49 vs 14.47 and 7.94). Only 13% of Micro IVF cycles had embryos for cryopreservation vs 69% with ConvIVF. There was no statistical difference in the CPR or IR(46%, 28% for Micro IVF vs 54%,38% for ConvIVF (p>0.05).Tabled 1Micro IVF vs Conventional IVF Cycles# of CyclesAvg # of Oocytes# of TransfersAvg Fertilization (# 2pn's)Avg # ETImplantation Rate (%)Clinical Preg Rate (CPR %)Micro IVF313.48±1.93282.19±1.721.68±1.0415/52 (28%)113/28 (46%)1Conventional IVF23314.47±8.012157.94±5.361.82±0.71151/393 (38%)1117/215 (54%)1CPR- Clinical Pregnancy rate defined as the presence of an intrauterine gestational sac. Implantation rate- defined as fetal hearts/number of embryos transferred. 1 p value>0.05, these numbers are not considered to be statistically significant. Open table in a new tab CPR- Clinical Pregnancy rate defined as the presence of an intrauterine gestational sac. Implantation rate- defined as fetal hearts/number of embryos transferred. 1 p value>0.05, these numbers are not considered to be statistically significant. There are many advantages to MicroIVF. Incidence of OHSS can be decreased significantly, with none noted in the Micro IVF group but 18 patients (8%) in the ConvIVF group had elective cryopreservation due to elevated estradiol (>3000pg/ml). Micro IVF is a more cost effective alternative but most patients do not have cryopreserved embryos to use for future cycles. Micro IVF cycle can be performed without impacting the CPR or IR.