Mild ovarian stimulation.
OBJECTIVE
To evaluate the efficacy of using only mild ovarian stimulation protocols for in vitro fertilization. Both groups with decreased and normal ovarian reserve were evaluated.


METHODS
Three different mild stimulation protocols were evaluated: natural with no exogenous follicle stimulation hormone (FSH) drugs at all, natural with a boost of low dose FSH to complete follicular maturation, and minimal stimulation with low dose (75-150IU) FSH from day 3-5 of the menstrual cycle. Ethinyl estradiol was sometimes used to lower high day 3 serum FSH.


RESULTS
Good pregnancy and implantation rates were found even in those women with elevated serum FSH that could only generate one follicle.


CONCLUSIONS
Mild ovarian stimulation seems preferable to high dose FSH regimens in women with elevated day 3 serum FSH based on previous poor reported pregnancy rates with the latter protocols. Comparable pregnancy rates to high dose regimen were seen in women with normal egg reserve at much lower risk and cost.
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Jerome H
JH
Department of Obstetrics and Gynecology, Cooper Hospital/University Medical Center, The University of Medicine and Dentistry of New Jersey, Camden, NJ, USA. laurie@ccivf.com
D000568:Amenorrhea / Q000150:complications; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D004967:Estrogens / Q000172:deficiency; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000191:economics; D005307:Fertilization in Vitro / Q000379:methods; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D006801:Humans; D007006:Hypogonadism / Q000150:complications; D007247:Infertility, Female / Q000188:drug therapy* / Q000191:economics / Q000209:etiology; D008423:Maternal Age; D009865:Oocytes / Q000502:physiology; D010062:Ovulation Induction / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome
D004967:Estrogens; D005300:Fertility Agents, Female; D005640:Follicle Stimulating Hormone