Over the past few decades, IVF has progressed immensely. Starting naturally, IVF initially followed a female’s natural hormone cycle producing usually one egg per cycle. From there, the use of modern medicine created a major shift in IVF to occur, allowing women to produce and harvest eggs in the double digits every cycle. It’s been said IVF is a numbers game. And in a way it is, but the main lesson we have learned over the years is that it’s about quality, not quantity. 

Some women who undergo IVF, especially those 39 and above, tend to have a low ovarian reserve. A low ovarian reserve basically means that a woman’s egg supply has significantly depleted and the max monthly number of viable eggs is low. There are lifestyle choices that potentially affect this, but in reality, the biggest contributor to a low ovarian reserve is age. 

Poor Responders and Low Ovarian Reserve

“Poor responder” is a term used in the IVF community to describe anyone who has gone through conventional IVF and continues to produce less than 8 eggs per cycle, even with high doses of medication. This is especially the case if the eggs that are harvested tend to follow a pattern of not fully developing to the blastocyst stage or show signs of being genetically abnormal. Generally, poor responders suffer from a lower ovarian reserve.

What makes Mini IVF a better solution?

It is important to note that there is no one set standard for treatment protocol in poor responders (Patrizio et al. 2015). If you are over 39 though and classified as a poor responder, Minimal Stimulation IVF, Mini IVF,  can increase your chances of pregnancy without the need for large doses of costly fertility medications. 

The Mini IVF protocol is defined by the practice of offering minimal medication/injections to achieve a higher amount of higher quality eggs despite the lower number retrieved. Even with Mini IVF there is no “one size fits all” protocol, but the goal is the same; to follow your natural hormone cycle with the help of low dose medications to produce between 4-8 good quality eggs per cycle.

As we know, women normally produce one mature egg every menstrual cycle. With fertility drugs, more eggs can be produced. However, for those over 39, generally, no matter how many eggs are harvested, only 1 or 2 tend to be good quality eggs that result in a live birth, especially for women with low ovarian reserve or classified as poor responders. 

Mini IVF vs Conventional IVF Success rates?

Studies have shown that Mini IVF and Conventional IVF have the same great success rates. Both protocols when applied to the right patients have proven to produce successful pregnancies. (Lambalk et al. 2017) Different medication doses have been tested and studied in those classified as poor responders to help physicians determine the optimal stimulation dose. (Datta et al. 2020). The conclusive evidence showed that birth rates stayed the same even with the minimal stimulation protocol.  

Our own New Hope study, from 2013, came to the same conclusive evidence that the quality of eggs produced through Mini IVF in poor responders is the same as the quality of eggs produced in a conventional cycle with a more responsive patient.

Mini IVF protocol:

  • Cycle monitoring through ultrasound imaging and blood tests
  • Surgical egg retrieval
  • Fertilization of egg and sperm in vitro via (ICSI)
  • Culture and monitoring of embryo(s) via EmbryoScope technology
  • Grading and selection of quality embryo(s) for fresh transfer and/or future (FET)
  • Single Embryo Transfer (SET)

Depending on each individual case, oral fertility medications like Clomid and Letrozole, are prescribed to gently stimulate her ovaries into producing multiple eggs. In some cases, three or fewer injectable medications like Follistim may be prescribed in combination with oral supplements to encourage egg production. Before retrieval, Synarel is delivered in the form of a nasal spray 36 hours prior to the procedure to trigger ovulation.

Natural IVF for Very Poor Responders

Natural IVF protocols were also studied in those considered “very poor responders.” A very poor responder would be a patient class that either has an extremely irregular period, has no more than 3 follicles at all times, has a baseline FSH of >20, or has an AMH <0.8. 

Natural/Natural Mini IVF has been found though to achieve pregnancy rates comparable to those of Conventional IVF on women that fit these classifications (Morgia et al. 2004; Kim et al. 2009) as these protocols are better tolerated by those patients and easier on the body (Hojgaard et al. 2001). 

Why Mini/Natural IVF?

  1. Save Time – Mini IVF and Natural IVF saves you time with their low dose/no dose protocol. Less time dealing with injections and medication means more time for other tasks. 
  2. Save Money – Less medication means lower costs for each cycle. 
  3. Less stress on the body – Little to no medication means fewer unnecessary hormones in the body and less stress on the ovaries. It also means less pain and more comfort with almost no personal injections! 
  4. Efficiency – Mini and Natural IVF are both efficient treatment plans with great success rates.

Why New Hope?

New Hope Fertility Center is home to world-renowned fertility specialists. We custom design fertility treatments for the individual to increase the chances of a successful pregnancy. Our specialists believe in putting the patient first and being with them through every step of the fertility journey. As the first facility to adopt the revolutionary Mini IVF protocol, our team is well versed in helping women of all ages reach their fertility goals. If you want compassionate fertility care, New Hope is the right place for you. Call us at (212) 517-7676 or schedule your initial consultation today!