Abstract
We present the minimal stimulation protocol for assisted reproductive technologies (ART) that we recommend for women with diminished ovarian reserve and/or advanced reproductive age. The protocol is individualized for each patient reflecting the heterogeneity of this patient population. The minimal stimulation requires assuring the follicle synchronization while keeping LH unsuppressed. Daily clomiphene citrate and, in some cases, daily letrozole are used throughout the entirety of the stimulation. Highly purified human menopausal gonadotropin is added on day 5 of stimulation to be used at 150 IU every other day. Close monitoring allows individualization of half-dose gonadotropin antagonist administration to prevent premature luteinizing hormone surge. This protocol is aimed at accumulating frozen embryos for elective frozen-thawed embryo transfer. Minimal stimulation for ART requires specific conditions and many allocated resources.
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