Minimal Stimulation IVF

MS IVF has been in use for some time in countries such as Japan and The Netherlands. The bad news is that in America, it may be a while before the competitive, market-based infertility industry makes MS IVF a viable and easily obtainable alternative to traditional IVF.

MS IVF vs. Traditional IVF

IVF is a fairly straightforward procedure that was originally developed to help women with tubal damage conceive. In IVF, the woman's egg is harvested, brought together with the sperm in a Petri dish for fertilization, and the embryo is then transferred to the woman's uterus. Ideally, implantation occurs and the pregnancy proceeds to a live birth.

Because fertilization and implantation don't always occur, the focus on IVF is to produce as many eggs as possible in each cycle, thus increasing the possibility of having sufficient eggs for fertilization and implantation. There are several drawbacks to this approach, including an increased risk of multiple pregnancies, the side-effects from the powerful drugs used to stimulate ovulation, and the moral/ethical implications of leftover embryos. Traditional IVF is also expensive, averaging $12,400 per procedure, according to the American Society for Reproductive Medicine. A large part of that expense is due to the high cost of the injectible fertility drugs.

The reason people make the physical, financial, and emotional investment is the undisputed fact that IVF helps many women achieve pregnancy every year. There is a great deal of controversy over the manner in which fertility clinics compute and report their success rates, but the Centers for Disease Control reports that in 2008, the success rate of IVF can be as high as 43 percent in women younger than 35.

By contrast, Dr. John J. Zhang of New Hope Fertility Center, says the typical cost for one cycle of MS IVF is $4,800. Because with MS IVF the woman takes only the relatively inexpensive oral fertility drug clomiphene citrate, the cost is much less and the side effects are negligible. Fewer eggs are produced—usually only one or two—but Dr. Zhang theorizes that egg quality is also improved because of the gentler approach to ovulation stimulation. He also says that this particular procedure relies on more meticulous work by the physician. Dr. Zhang claims success rates close to those of traditional IVF, but his data has not yet been independently verified and published in a peer reviewed journal.

"I actually modified this technique from my colleagues in Japan; they've been doing this for 10 years," says Dr. Zhang. "It's also common in European countries such as Denmark, Sweden, Belgium, and The Netherlands."

The Future of IVF?

Dr. Mark Leondires, medical director for Reproductive Medicine Associates of Connecticut, would like to think that minimal stimulation is the wave of the future. Unfortunately, the realities of the American market don't make it feasible for most clinics at this time, because the focus is profit, and profit comes from high success rates.

"In the countries where they've been doing [minimal stimulation IVF] for a while, it's generally covered by insurance, so there's a lot less pressure to get more eggs," says Dr. Leondires. "But the fact is that the best clinics in Europe can't hold a candle to us. They'll tolerate a 45 percent success rate; we're shooting for 60 percent."

Since in America IVF often is not covered by insurance, or only covered on a limited basis, Dr. Leondires says that patients want more bang for their buck. They'll shy away from a procedure that generates only one or two eggs—thus only one or two chances at pregnancy—over a procedure that may allow them to harvest enough eggs for several IVF attempts. There's also no proof yet that the more gentle stimulation guarantees better quality eggs.