A novel ovarian stimulation protocol for use with the assisted reproductive technologies.
OBJECTIVE
To determine whether a new ovarian stimulation protocol termed "minimal stimulation" provides pregnancy rates (PRs) comparable with those in a conventional full stimulation protocol for patients undergoing assisted reproductive technologies (ART).


METHODS
Prospective, nonrandomized study of patients in minimal stimulation or full stimulation, followed by standard IVF and zygote intrafallopian transfer or uterine-ET.


METHODS
The ART program of the Mayo Clinic, Rochester, Minnesota.


METHODS
Women (n = 120) 42 years of age or younger with serum day 3 FSH level < or = 15.0 mIU/mL (conversion factor to SI unit, 1.0), normal thyroid-stimulating hormone and PRL levels, normal endometrial cavity as observed on hysterosalpingogram, and partners with a normal semen analysis.


METHODS
Oral clomiphene citrate, hMG, oocyte retrieval, IVF-ET.


METHODS
Cancellations, implantation, pregnancy.


RESULTS
The cancellation rate was not significantly higher in minimal stimulation (25.8%) than in full stimulation (14.1%). Minimal stimulation cycles yielded fewer oocytes per aspiration (3.4 +/- 1.6) than full stimulation (10.1 +/- 5.4). There was no difference in the implantation rates per ET (minimal stimulation, 16.4%; full stimulation, 13.3%) or overall clinical PRs per retrieval (minimal stimulation, 31%; full stimulation, 42%).


CONCLUSIONS
Minimal stimulation for IVF is less expensive than full stimulation and minimizes monitoring and patient discomfort. In addition, it produces acceptable PRs and represents an attractive alternative to select patients undergoing ART.
Corfman
R S
RS
Department of Obstetrics and Gynecology, Mayo Clinic Rochester, Minnesota.
Milad
M P
MP
Bellavance
T L
TL
Ory
S J
SJ
Erickson
L D
LD
Ball
G D
GD
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use*; D010064:Embryo Implantation; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D007248:Infertility, Male; D008297:Male; D008596:Menotropins / Q000627:therapeutic use*; D009865:Oocytes; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D012099:Reproductive Techniques; D013084:Sperm-Ovum Interactions; D013972:Thyrotropin / Q000097:blood; D016896:Treatment Outcome
D002996:Clomiphene; D008596:Menotropins; D011388:Prolactin; D005640:Follicle Stimulating Hormone; D013972:Thyrotropin