If you're hesitant about the side effects and price of conventional In Vitro Fertilization, you may have heard about a newer procedure, Minimal Stimulation In Vitro Fertilization. Dubbed the Mini-IVF, this procedure is half the price of the usual IVF, with fewer doses of medication required, and far less side effects. And, of course, it still gets you on the way to having a baby.
Mini-IVF consists of a daily low-dose pill, usually Clomid and/or Lethrozole—which helps kick-start egg production—for 10 to 12 days. Ultrasounds are required every few days to check whether the eggs are developing healthily. Within this time, the patient will need to give herself a "trigger injection" of Follitropin (more commonly called Gonal-F) in the belly. This helps stimulate the egg to maturity. Within the next 24-48 hours after the shot is given, the eggs should be mature enough to have an egg retrieval operation. This is normally done under anesthetia, although a woman can opt to have the surgery without it.
The amount of medications used in Mini-IVF is significantly less than needed in conventional IVF. This helps to keep costs down and minimizes the amount of hormones a woman is taking into her body, explained Zaher Merhi, M.D., FACOG, the director of IVF Research at New York's New Hope Fertility Clinic. "You don't actually need as much medication to help conception since the medication doesn't create eggs, it only fosters the growth of the eggs that are already there," according to Dr. Merhi. "Medication is like egg food, so if you have a lot of eggs, then a lot of medication may be fine because there's numerous eggs to feed," he said. "If you have a low number of eggs, then all you need is a little bit of food." In other words, the amount of medication administered during Mini-IVF is tailored specifically for each patient based on her egg reserve.
This makes Mini-IVF a great option for women who do not have many eggs, which is more common in women over the age of 35. According to a 2013 trial involving 520 women which was showcased at the American Society for Reproductive Medicine conference in Boston, success rates for Mini-IVF in women over 35 were a third higher and women in their 40s were twice as likely to have a baby with Mini-IVF compared to if they had used conventional IVF.
Mini-IVF is also an option for women who are considering or have had Ovarian Rejuvenation, a fairly new process used to gently stimulate the ovaries, to help with the creation and release of new eggs. "We know that the surface of the ovary becomes tough like leather, with age," he says. "This rigidity can put pressure on follicles that squash developing eggs in older women. Mini-IVF most often will not compromise the work done with rejuvenation. It's more gentle with follicle stimulation than conventional IVF, which can negatively impact the quality of the egg."
Dr. Merhi and his team recently moved to needle-free Mini-IVF, a procedure they developed. Normally, women need multiple blood draws in order to monitor their hormone levels in preparation for egg retrieval, but "I'm afraid of needles myself and I saw women who were afraid of shots having to get them multiple times," he said. So instead, he solely monitors the hormone levels in saliva and urine, which he sees is as accurate as blood draws.
"To be most successful with Mini-IVF, I recommend you trust your doctor and avoid stress, which may negatively affect the outcome," Dr. Merhi said.