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The Center for Fertility and Gynecology

What is mini-ivf?

By on August 31, 2012

Mini-IVF

At our Los Angeles based fertility center, the Center for Fertility and Gynecology, we encounter a wide variety of patient types.  As part of our mission to treat every patient as an individual, we have developed a fittingly wide variety of treatment options to meet theses patient’s needs.  One of these treatment options is a variation of traditional IVF which is called “mini” IVF.

What is mini-IVF

Mini IVF has nothing to do with Mini Mouse!  Mini-IVF is best thought of as a different approach to the IVF process.  It involves using lower amounts and less types of medication to obtain eggs for IVF.  To understand how a mini-IVF cycle differs from a standard IVF cycle, we need to establish how a standard IVF cycle is conducted.  During a standard IVF protocol, up to 4 different classes of medications may be used over the 10 day stimulation period.  These classes include medications for:

1.       Ovulation prevention- A GnRH agonist such as luprolide acetate or GnRH antagonists such as Ganerelix are both used to prevent ovulation during an IVF cycle. 

2.       Egg stimulation- There are several types of gonadotropin injections, or oral tablets which function to stimulate follicular (egg) growth. 

3.       Supplemental- Other medications such as human growth hormone, interlipid or Luvaris may be added to improve embryo quality or affect the uterine environment.

4.       Trigger shot- natural or recombinant HCG induces the final maturation of the eggs and allows us to retrieve the eggs from the follicles.

During a mini-IVF cycle, we will either use no medications from class 1, or only a few days of a GnRH antagonist.  From class 2, a significantly lower dose of stimulation medication is used.  Sometimes we forgo class 2 medications altogether, this is referred to as “Natural” IVF. Class 3 medications are usually omitted completely in mini-IVF and class 4, the trigger shot, remains the same as standard IVF.  The final result of this approach is a less intensive and less expensive IVF cycle.  Importantly, fewer eggs are usually available with mini-IVF as compared to standard-IVF, but in some women, the egg quality may improve. 

Who is a good candidate for mini-IVF?

Women who produce a small number of eggs (1-4) with standard IVF doses are good candidates for mini-IVF.  For these women, a mini-IVF cycle which results in 1-3 eggs is really not very different than a standard cycle.  Additionally, the lower doses of medication may help to improve egg quality.

Another group of women who are good candidates for mini-IVF are those with poor egg quality issues.  Sometimes, the mini approach produces eggs with higher quality than standard IVF. 

Lastly, some women prefer mini-IVF for ideological reasons.  They prefer to limit their medication exposure and want to keep things as “natural’ as possible.  Also, women with some types of medical conditions and malignancies are better suited to mini-IVF.

What are the downsides to mini-IVF?

Mini-IVF may result in fewer eggs than standard IVF.  Logically, one may think that fewer eggs mean fewer embryos and therefore a lower chance for pregnancy.  Interestingly, we believe that in some select groups, the opposite is actually true. 

Another downside to mini-IVF is that there is a higher risk of not retrieving any eggs.  Due to the fact that some women will naturally ovulate early when we use little or no medication to prevent ovulation, we occasionally find that there are no eggs available at the time of retrieval.

If you have questions about mini-IVF or would like to discuss different IVF treatment protocols, feel free to contact us, we’d be happy to speak with you. 

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