What is mini IVF?

Lower costs with greater safety, using no hormones or minimal doses with Mini IVF!

In vitro fertilization treatments   can be considered too aggressive by some patients, largely due to the need to use high doses of hormones to produce eggs. These hormones produce adverse effects that can be more intense in some patients and even harmful in others (risks of thrombosis or neoplasms). There are also some patients who cannot use this type of medication, such as patients who have had breast cancer, for example. Thus, we can use minimally invasive IVF techniques. These techniques can be summarized into three types: natural cycle, minimal stimulation, and in vitro maturation (IVM).

NATURAL CYCLE:

This technique can be used in all patients who ovulate normally. Young women who wish to avoid ovarian stimulation with hormones can try a natural cycle beforehand. We also have very good results in older women and those who have previously shown little response to conventional induction. It is the indicated treatment for women who – by choice and conception – do not want to use medications for controlled ovarian stimulation. This includes women who cannot receive hormones due to the risk of developing hormone-dependent neoplasms (cancer) (such as breast cancer, for example). It is a safer and healthier technique than conventional treatment that uses high doses of hormones.

The total cost of treatment is significantly lower than conventional treatment, considering that medications account for between 40 and 50% of the cost of in vitro fertilization. There is no suppression of the ovaries, nor the onset of menopausal symptoms (relatively common in some types of hormonal stimulation), and the treatment cycle is completed following the natural growth of the woman's egg.

What is the natural cycle for IVF?

In short, and simply put, it's an IVF treatment performed without the use of medication. In conventional IVF or  ICSI treatments , patients receive high doses of hormones so that the ovaries produce many eggs. In a natural IVF cycle, the ovary produces only one follicle, which develops naturally and spontaneously, producing only one egg (although it's possible for more than one egg to develop naturally, or even none at all). This is not an innovative or revolutionary treatment. It's simply a different approach and a way to avoid harming the body with the risks associated with hormones, such as thrombosis, neoplasms, ovarian hyperstimulation syndrome, among others. Louise Brown, the first child born through IVF in the world, was conceived in a natural cycle; this was in 1978.

There are safe and effective methods that allow for the preservation of fertility before a woman loses the quality and quantity of her eggs, ensuring low risks of malformations and genetic syndromes.

Does this mean that hormones are not used in this IVF technique?

There are no side effects such as mood swings, fluid retention, swelling, ovarian hyperstimulation syndrome, and other conditions related to ovarian stimulation. Due to the effects of medications on the body, patients undergoing conventional treatments must wait an average of two months to repeat the treatment; in contrast, patients undergoing natural cycles can undergo treatment in successive months without the need for breaks. As only one embryo is transferred in natural cycles, a multiple pregnancy is virtually impossible (unless the embryo splits in two; the risk for this is 1 in 1,000 treatments). Furthermore, ovarian stimulation medications are very expensive, and natural cycles are much cheaper than conventional treatment (between 40 and 50% less).

What are the disadvantages of the natural cycle?

Success rates are low compared to conventional treatment. There is also a high risk of spontaneous ovulation before egg retrieval (if hormonal blockade is not performed) and of not having any eggs produced in the cycle.

Who can undergo natural cyclism for IVF?

Women under 45 who ovulate normally may be candidates for this type of treatment.

Who cannot undergo natural cyclism for IVF?

Women who do not ovulate regularly. In this case, we should employ minimal stimulation or in vitro maturation.

MINIMUM STIMULUS:

This is an adaptation of conventional IVF treatment. The difference is that we use very low doses of hormones, usually 75 units on alternate days, contrasting with 225, 300 or more units per day in conventional treatments. The goal is to obtain a small number of eggs, between 2 and 7. We do not perform prior pituitary suppression; we start treatment synchronously with the normal menstrual cycle. Spontaneous ovulation is induced so that we can collect the eggs. This type of treatment is safe, cheaper, and minimizes – or even eliminates – the side effects of conventional stimulation. Ovarian Hyperstimulation Syndrome is also a rarity in this treatment modality.

In Vitro Maturation (IVM):

In vitro maturation is a widely used technique in veterinary medicine, such as in cattle. The idea behind this treatment is to remove eggs from the ovaries before they undergo the selection and apoptosis process (when the ovary causes only one egg to continue growing in that cycle). Thus, we remove immature eggs before the dominant follicle begins to form. The immature eggs are then taken to the laboratory (in vitro) and placed in a special hormone culture to "mature" them. When the eggs are finally mature, semen is collected from the husband and then fertilization is performed. From then on, the steps are identical to those of conventional IVF.

What are the advantages of IVM?

In vitro maturation eliminates the need to administer hormones to the woman, sparing her all the consequences and risks of this stimulation.

What are the disadvantages of IVM?

IVM still shows inferior results compared to conventional IVF. It is considered an experimental procedure and is still under development.

Who can participate in IVM?

As a rule, women with polycystic ovaries are the best candidates for this treatment, since they have numerous immature eggs in the ovary at the same time. Other conditions in which women have a good ovarian reserve (more than 10 antral follicles counted on ultrasound) also make IVM possible. Women undergoing cancer treatment are also good candidates for this treatment.

Who is not eligible to perform IVM?

The treatment is not recommended for older women or those who do not have a large number of eggs (ovarian reserve).