The Future of IVF

What Is Minimal Stimulation?

By Kelly Burgess

It sounds too good to be true: IVF without painful injections, debilitating side effects, multiple births or the dilemma of how to deal with leftover embryos. The good news is that this technology exists; it's called minimal stimulation in vitro fertilization (MS IVF), and it's 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 in vitro fertilization (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 2003, the most recent year full data is available, the success rate of IVF can be as high as 37 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.

Want to see more?

• High Tech Babies: In vitro Fertilization
• High Tech Babies: Artificial Insemination
• Spousal Support: A Male Perspective on IVF
• Talk about it!