Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-28T04:23:32.706Z Has data issue: false hasContentIssue false

44B - There Is No Place for Natural and Mild Stimulation IVF

Against

from Section VIII - Ovarian Stimulation

Published online by Cambridge University Press:  25 November 2021

By
Ippokratis Sarris
Edited by
Roy Homburg ,
Adam H. Balen  and
Robert F. Casper
Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
Get access

Summary

Optimal IVF entails establishing the balance between safety, oocyte/embryo quality, pregnancy and live birth outcomes, patient views and cost. Conventional ovarian stimulation (cOS) may well result in good outcomes for the majority of couples undergoing IVF. However, for certain cohorts of patients this method may result in suboptimal responses and therefore outcomes. The question is not if natural and mild stimulation (mOS) IVF are better than conventional, but if there is no place for these at all. We should not treat all of our patients the same and must acknowledge that dismissing these protocols from the armoury of our medical practice is a mistake. As will become clear from the debate, the statement that ‘There is no place for natural and mild stimulation IVF’ is simply wrong.

Type
Chapter
Information
50 Big Debates in Reproductive Medicine , pp. 230 - 234
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Nargund, G, Fauser, BCJM, Macklon, NS, et al. The ISMAAR proposal on terminology for ovarian stimulation for IVF. Hum Reprod. 2007;22:2801–4.CrossRefGoogle ScholarPubMed
Yeh, JS, Steward, RG, Dude, AM, et al. Pregnancy rates in donor oocyte cycles compared to similar autologous in vitro fertilization cycles: an analysis of 26,457 fresh cycles from the Society for Assisted Reproductive Technology. Fertil Steril. 2014;101:967–73.CrossRefGoogle Scholar
Sunkara, S, La Marca, A, Seed, PT, et al. Increased risk of preterm birth and low birthweight with very high number of oocytes following IVF: an analysis of 65,868 singleton live birth outcomes. Hum Reprod. 2015;30(6):1473–80.CrossRefGoogle ScholarPubMed
Baart, EB, Martini, E, Eijkemans, MJ, et al. Milder ovarian stimulation for in-vitro fertilization reduces aneuploidy in the human preimplantation embryo: a randomized controlled trial. Hum Reprod. 2007;22:980–8.CrossRefGoogle ScholarPubMed
Vermey, BG, Chua, SJ, Zafarmand, MH, et al. Is there an association between oocyte number and embryo quality? A systematic review and meta-analysis. RBMO. 2019;39:751–63.Google Scholar
Polyzos, NP, Drakopoulos, P, Parra, J, et al. Cumulative live birth rates according to the number of oocytes retrieved after the first ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection: a multicenter multinational analysis including ∼15,000 women. Fertil Steril. 2018;110:661–70.CrossRefGoogle Scholar
Smeltzer, S, Acharya, K, Truong, T, et al. Clinical pregnancy (CP) and live birth (LB) increase significantly with each additional fertilized oocyte up to 9 and CP and LB declines after that: an analysis of 15,803 first fresh in vitro fertilization (IVF) cycles from the SART registry. Fertil Steril. 2019;112:520–6.Google Scholar
Lainas, TG, Sfontouris, IA, Venetis, CA, et al. Live birth rates after modified natural cycle compared with high-dose FSH stimulation using GnRH antagonists in poor responders Human Reprod. 2015;30:2321–30.CrossRefGoogle ScholarPubMed
Practice Committee of the American Society for Reproductive Medicine. Comparison of pregnancy rates for poor responders using IVF with mild ovarian stimulation versus conventional IVF: a guideline. Fertil Steril. 2018;109(6):993–9.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×