We offer lower cost alternatives to Standard IVF: Natural IVF and Mini Stim IVF. Instead of aggressively stimulating the ovaries with high dose medication and then doing an egg retrieval, we can use one of these methods to achieve similar outcomes at a lower cost.
At a Glance
- Less stressful because no or low doses of medicine are used
- Monitoring is minimal
- Less costly that standard IVF
- Egg retrievals require no anesthesia
- Embryo biopsy for genetic analysis is included in the price
- ICSI is also included in male factor situations
Lower Cost, Less Medication & Less Stress
Natural IVF got its start because women didn’t like all of the injections. Doctors in Japan developed Natural IVF to find ways to help these women conceive without all of the medication associated with conventional IVF. Since then, Natural IVF has morphed into a very effective way to have excellent outcomes without pushing the ovaries to their max.
Through the years, it has been discovered that “more is not always better.” In conventional IVF, the embryos which develop generally come from the best of the eggs and the other eggs have lower potential. In the Mini Stim IVF approach, lower numbers of follicles are developed and fewer, but sometimes higher quality eggs are retrieved.
Natural IVF uses no injectable medication. Mini Stim IVF is a hybrid of Natural where we use very low doses of medication. The Natural IVF and Mini Stim IVF approaches can produce the same number of pregnancies as a single cycle of conventional IVF. However, since very low drug doses are used, it is more cost effective for the patient. In conventional IVF, about a third of the patient’s cost is allocated to the use of the drugs.
How Natural IVF Works
Instead of stimulating the ovaries vigorously once and doing an egg retrieval, the same outcome can be achieved, at lower cost, by doing up to three cycles of Natural IVF. Egg retrievals are done without anesthesia using a tiny needle. It is done very quickly, and patients tolerate this very well. Anesthesia is available for those who request it at extra cost.
Once the eggs are obtained, conventional IVF laboratory procedures are followed. The eggs and sperm are placed together in the dish or intracytoplasmic sperm injection (ICSI) is used in cases of male factor. Fertilization is followed by embryo development. Five days later, if an embryo develops to the 80 to 100-cell stage called a blastocyst, it can be biopsied for genetic analysis, then frozen.
Once one or two chromosomally normal embryos are obtained, an embryo transfer can be performed with estrogen and progesterone medication. This is no different from a conventional IVF frozen embryo transfer procedure.
How Mini Stim IVF Works
Mini Stim IVF is a hybrid of Natural IVF. Low doses of oral and injectable drugs are used, and monitoring is minimal. In this approach a modest number of follicles develop. The same procedure as Natural IVF is followed once the follicles develop.
Natural & Mini Stim IVF Candidates
No one is excluded from this program because of age, AMH or past history. Patients who have poor prognosis are offered the egg donation option. If this is not acceptable, Mini Stim IVF is more cost effective than conventional IVF for poor prognosis patients because the high doses of expensive injectable gonadotropin often used are ineffective in conventional IVF. Below are women who are good candidates for Natural IVF or Mini Stim IVF.
- who have been told the only way they will conceive is with an egg donor
- with diminished ovarian reserve (DOR)
- who do not want lots of surplus embryos after conceiving
- who do not tolerate the injection medication well
- looking for a low-cost option
- with PCOS
- with no fallopian tubes
- who want a more natural approach to conceiving
- who want to do preimplantation genetic screening (PGT)
Physicians often advise older patients in their 40’s who fail IVF to stop trying to use their own eggs and move to egg donor since that option offers 60% to 80% success. However, not everyone is ready to make that leap; some women want to keep trying with their own eggs. While egg donor is a wonderful solution for many people, for those who find that option unacceptable, persistence is the key word.
For older patients with diminished ovarian reserve (DOR), more gonadotropins does not result in more eggs retrieved. These patients are generally wasting their money on medication in conventional IVF. With Natural and Mini Stim IVF, most of our patients choose a 3-cycle package. They have an egg retrieval with no anesthesia three months in a row. With all of the embryos biopsied and frozen, they can have a transfer with a normal embryo the next month. Once a normal embryo is created, even in a 44-year-old, the chances for implantation and a baby from this embryo are nearly as good as they are for a 30-year-old.
All of this is very low stress because their lives are not overtaken by all of the daily injections and monitoring.
Low Ovarian Reserve
Younger women who have diminished ovarian reserve can be considered to have premature ovarian aging. Similar to 44-year-old patients, sometimes only 10% of eggs and their resulting embryos are chromosomally normal or euploid. Patients with low ovarian reserve have an elevated FSH level. Conventional IVF often tries to stimulate follicles by using a high dose of gonadotropins (FSH). Since these patients already have an elevated FSH, the stimulation does not produce more eggs. Also, the quality of the eggs can be negatively affected by high dose stimulation. So, Mini Stim can work just like it can in an older woman. It can be just as effective as conventional IVF, just easier and less expensive.
Mini Stim IVF vs Conventional IVF
The three elements which are so taxing in conventional IVF are:
- Time – lots of tests, ultrasounds, doctor’s visits, and waiting room time
- Money – the procedures and the drugs add up to considerable amounts
- Stress – intense treatment cycles occupy one’s life
The first two add to the emotional stress, which is unresolved when patients do not conceive. Mini Stim IVF requires less of each of these elements and gives hope to patients who need to persist. It is often impractical to keep doing conventional IVF due to the cost, even at a low-cost IVF center like Pathways Fertility.
If you have tried IVF and you are thinking about trying Mini Stim IVF, on the surface it may seem counterintuitive. You have always been told that the goal is to get as many eggs as possible. Natural IVF and Mini Stim IVF is a way to keep trying with less money and stress compared to conventional IVF. Typically, one mid cycle ultrasound can be done, and the date of trigger can be set. You walk into the egg retrieval fully alert, endure a couple of minutes of being uncomfortable, and you are free to go about your day. No post anesthesia recovery time. No one has to take you home. You could even go back to work.
As a part of the Natural IVF and Mini Stim IVF, a unique feature is the recommended use of preimplantation genetic testing. This analysis of the chromosomes in each embryo means that we only transfer normal embryos, improving the chances of a successful pregnancy.
We offer a discount on the biopsy in our 3-cycle packages.
The Mini Stim IVF Procedure
You will stop your birth control pills on a Sunday. Then, on day #6 or #7 you start on oral pills, clomiphene, every day until you are ready for the trigger drug. Sometimes a low dose of injectable gonadotropin is added for a few days.
The clomiphene stimulates the ovaries to produce a few follicles, but it also, in the prolonged administration mode, suppresses the premature release of LH. This keeps you from ovulating before we are ready. When the follicles are the proper size, which is somewhere between 18 and 24 mm for the largest follicles, a trigger drug is given.
Hear more directly from Dr. Dourron