What is Micro IVF?

Micro IVF in general can be described as taking either solely oral fertility meds with or without minimal use or injectable gonadotropins when going through InVitro fertilization. The process is the same as doing conventional IVF which entails egg retrieval, fertilization, embryo culture and embryo transfer. This process can diminish the risk of multiple births. Some center offer this procedure at a lower cost than conventional IVF plus there are additional savings from having to purchase less fertility meds.

Minimal Stimulation IVF. IVF over the past twenty years has evolved and been optimized from a point where pregnancy rates were at best quoted to be 10% to about 50% today. We have become better with our stimulation protocols and techniques over this time period and are continuing this trend. Nevertheless, this success has its unintended consequences being the possibility of an overproduction of embryos along with multiple embryos being transferred.

Minimal Stimulation IVF is currently being touted as a solution for this, and we all hope that it soon will. However, we currently lack good data from proper clinical trials to support its use without adequate patient consent when gonadotropins/IUI cycle may be appropriate for sub-fertility. In one of the better trials to date from Pelinck et al (Netherlands), they noted an 8% pregnancy rate, with a 20.8% pregnancy rate after three attempts with Minimal Stimulation IVF. It is well accepted that couples with Unexplained Infertility, the pregnancy rate for gonadotropins/IUI is 17%. Some authors have published success rates of up to 40% using Minimal Stimulation IVF, but these percentages may be influenced by bias and other study errors due to their retrospective design.

I welcome the use of Minimal Stimulation so long as the patient is fully aware of the option to use conventional dosing for IVF to achieve accepted pregnancy rates. Centers are touting the diminished cost when providing this service, but the patient should be aware that if this particular treatment it’s not right for them they could end up spending money on a treatment that won’t increase their chances of pregnancy. There will also be a significantly increased possibility of having frozen embryos for future use when undergoing conventional stimulation. With the use of gonadotropins agonists for an ovulatory trigger, the risk of OHSS development has been shown to be significantly diminished without compromising pregnancy rates.

More data needs to become available to truly assess the success of this procedure for different types of patients and all Fertility Specialists should follow this closely to assess whether or not it could be a solution for some of their patients while clearly providing all their available options with associated costs.

One should consider that it is generally accepted that IVF does slightly increase the risk of birth defects since our synthetic culture media and incubators may never be as good as the environment provided by a mate
al womb. These are some considerations that should be taken before performing IVF routinely and without indication when other options are readily available.

Dr. Rudy Quintero is a Fertility Doctor in Los Angeles, founder of www.CareFertility.net

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