Mini IVF

Is mini IVF the same thing as conventional IVF?

The answer is both yes and no. For most part, mini IVF is identical to conventional IVF. However, the two have some differences too.

In mini IVF, also referred as minimal stimulation IVF or micro IVF, fewer eggs are used than conventional IVF. In a typical mini IVF treatment cycle only 2 eggs are used for fertilization, while in a conventional IVF cycle several eggs are retrieved and fertilized. Therefore, in the mini IVF treatment the patient is given weaker ovulation-induction drugs or fewer doses of the usual ovulation-induction drugs. For instance, while in a normal IVF cycle the patient is given gonadotropins to ensure the production of several eggs during ovulation, the patient is given Clomid (a weaker drug in comparison to gonadotropins) or fewer doses of gonadotropins in a mini IVF cycle. 

Another difference between the two lies in the number of embryos (fertilized eggs) implanted inside the uterus. Only one embryo is implanted in mini IVF, whereas in conventional IVF 1 to 3 embryos can be implanted.

In a few cases, the patient may not be administered any ovaries-stimulating drugs during a mini IVF cycle. This usually happens when the couple's infertility is due to male fertility problems. Your doctor may also decide against using any ovulation-stimulating drugs if your fallopian tubes are blocked. However, women who have ovulation problems are most certainly asked to take an ovaries-stimulating medication for a few days. In mini IVF, just like in case of IVF, a patient may be also asked to use Cetrotide or any other GnRH antagonist to regulate ovulation.

The remaining steps, retrieval of eggs, fertilization of eggs, and implantation of embryos (fertilized eggs), are same in both the procedures.

What are the advantages of mini IVF?

Mini IVF has three main advantages:

• It is less costly than conventional IVF. A mini IVF cycle costs anything between $5,000 to $7,000, whereas a conventional IVF costs at least $15,000
• The risk of multiple births in mini IVF is lower than in conventional IVF
• The risk of ovarian hyperstimulation syndrome (OHSS) is less in mini IVF

What are the disadvantages of mini IVF?

The main disadvantages of mini IVF are:

• Mini IVF has a lower success rate than the usual IVF.
• Mini IVF may prove costlier than the usual IVF in the long run. While this statement appears to contradict what has been listed in the first point under the advantages of mini IVF, both statements are absolutely true. One cycle of mini IVF is less expensive than one cycle of usual IVF, as shown above. However, as the success rate of mini IVF is lower than the usual IVF, you may need to undergo many IVF cycles before you are able to conceive.
• Mini IVF is not suitable for someone who wants to store unused embryos for future use, because only 2 eggs are retrieved during the procedure. At the end of a mini IVF cycle, at the best, you will have only one unused embryo. As not all frozen embryos can be used for implantation later, spending money on storing one embryo does not make much sense.

Natural Cycle IVF

What does the term 'natural cycle IVF' means?

IVF, as you may know, stands for in vitro fertilization. In other words, in IVF the fertilization occurs in the laboratory and not inside the female body. In a usual IVF cycle, the female is given ovulation induction drugs to ensure the production of more eggs during ovulation. A natural cycle IVF, on the other hand, is an IVF cycle in which the ovulation is not manipulated. That is, the ovulation occurs normally, resulting in production of only one egg. And it is this egg, produced through normal ovulation, which is fertilized in the laboratory, much like what happens in a usual IVF cycle, by bringing it in contact with sperm.

How can I know for sure if natural cycle IVF is for me?

A natural cycle IVF is a good option for you if you have regular menstruation cycles and ovulate normally and if any of the following holds true for you:

• You cannot take fertility drugs (for example: fertility drugs may not be suitable for cancer patients and women who have an increased risk of ovarian hyper-stimulation)
• You do not want to interfere with the natural ovulation process because of religious or personal beliefs

What are the different steps involved in a natural cycle IVF?

Apart from the ovulation induction step, a natural cycle IVF is identical to the usual IVF cycle. Shared ahead is a brief description of the steps you would go through if you opt for this fertility treatment:

Step 1 - Collection of your egg and sperm

Experts at your clinic will collect your egg during ovulation. At the same time, your male partner will asked to give a sperm sample.

Step 2 - Fertilization

Next, the experts will bring the egg and sperm together to initiate fertilization.

Step 3 - Observing the embryo

The fertilized egg, or embryo, will be observed for a day or two to ascertain everything is going alright.

Step 4 - Implantation of the embryo in your womb

Lastly, the doctors will implant the embryo in your uterus. 

Once the embryo is implanted, there is nothing to do but wait. After 10-15 days, you will have to undergo certain tests-probably a blood test and an ultrasound test-to check if the treatment is successful.

What are the risks associated with a natural cycle IVF?

A natural cycle IVF is safer than the usual IVF on two counts:

• It does not require administration of fertility drugs. Therefore you do not experience the side effects of these drugs; and
• Only one embryo is implanted, so the risk of multiple births is considerably less-almost as low as it is in natural pregnancy.

What are the success rates of natural IVF?

A lot of information is not available about how successful, or unsuccessful, this fertility treatment is. Whatever information is available point towards only one thing-the natural IVF is not as successful as the conventional IVF. This is because in a natural cycle IVF only one egg is used, whereas in a conventional cycle IVF multiple eggs are used.

SEVEN IMPORTANT FACTS YOU SHOULD KNOW ABOUT IVF AND THE CENTERS

The drive to have a family is a very strong natural urge in most individuals or couples, and its due to this that IVF treatments will continue to be an avenue for those in need of it, even in the face of many unanswered questions. When considering this as an avenue to explore or go down, one should know the answers of at least some of the main questions regarding IVF procedures and centers. Here are some examples..

1. What is the real success rate for IVF ?

Centres usually declare their success rates to be between 40 and 60 % per standard trial. However, in most circumstances what can influence or determine your success as an individual is you yourself. Each individual couple's chance of success depends on a number of varying factors such as age, cause of infertility and lifestyle etc. In general, for women in age groups below 35 years, each IVF trial has a success of 50 %. This significantly decreases over the age of 40 years, and for women at and over the age of 45 years, the chance is below 5% (with some exceptions).

It must be remembered however, that 'chance' always plays an important role in success. Our experience over the years has shown that for the vast majority of those who resisted and continued forging their way forward without losing their hope or confidence usually ended up with the joy of being hande d their babies at the end. Having said that, and regarding persistence, it's worth noting that if a couple or individual do not obtain success after three attempts in the same centre, then perhaps it's best attempting treatment at other centers. This is less to do with the failure of original centre, but more to do with enabling the couple or individual to make a psychological change.

2. Is IVF really expensive as they demand ?

Success certainly comes first, but the financial burden on the patient is often so great that many couples feel that they can only afford one cycle and therefore face the added stress of trying to maximize their one and only chance to conceive in that cycle, or get pregnant on the first try.

If you look at IVF prices in developed countries, it ranges between $10,000- $15,000 in US and 4500-5000GBP in UK per cycle. Besides, these prices do not cover the drug expenses and most centres charge the techniques ICSI, AHA, blastocyst culture etc. additionally. I recommend evaluating experienced centres with at least 50 cycles per month and over, to compare costs and make your selection then. On the other hand, countries like Turkey has affordable prices with high success rates. Expenses can be minimised to one-third of the high costs mentioned above and combining your medical treatment with a vacation in these countries is quite possible.

3. Is it harmful for my health ?

Every patient who is considering using IVF probably asks herself this question before she starts treatment. IVF treatment has been practiced for more than 30 years all over the world. Remember that more than four million IVF babies have been born since the earliest IVF successes in 1978. Lots of investigations have been carried out on the fact that IVF is a safe procedure when performed carefully. Today, as treatment is carried out by an experienced physician in a experienced centre, hardly a serious problem arise. Of course, as in any attempt to treat, unexpected problems and complications may occur in the rate of 1-2 %. These problems can be solved by a very large extent on careful observation and experience. The most common problem is the collection of fluid in the abdomen, bloating, excessive arousal table presenting the findings of the need for hospitalization called hyperstimulation syndrome and is about 1-2 % in experienced centres. Myths like IVF causes cancer are not at all true or based on medical findings .

4. You cannot change the age and capacity of your ovaries.

Every woman is most fertile between the ages of 20 and 30. Fertility starts to decline significantly from the age of 35. The decline in number of eggs with age is an important issue in IVF. However, egg quality and fertilization rates are also reduced from 35 years of age. There are several tests to help you to comment on that. AMH blood test (AMH) is a marker for ovarian reserve and provide information on the number of eggs to be obtained but not about the quality of the eggs. It is an indirect way of evaluating how well the ovaries are working.
Nature behaves differently in different individuals. So whilst on one hand one woman may have a wealth of ovarian capacity, another woman may unfairly suffer from the onset of menopause at an early age. The same situation is also true for men. Some may have hundreds of millions of sperm in their counts whilst some others may have very low or even none existent sperm in their counts. Unfortunately based on such a genetic characteristics, there is no specific treatment can be done. Remember that, you cannot produce new eggs and sperms, but in vitro fertilization treatment uses what exists. Perhaps this fact is subject to change with the development of stem cell therapies in the near future. We hope that this process will not take too long.

5. There is also physical and emotional cost of IVF treatment.

The majority of couples describe the IVF experience as financialy, physically and emotionally demanding. Physical side effects can include headaches, insomnia, bloating, fatigue and emotional fluctuations. Many also find the IVF experience stressful as they go through the painful process of waiting for the result. Reputable clinics offer specially trained psychological counselling services to help people through the emotionally challenging aspects of IVF. Of course, not every couple is requiring this services. In this regard, note that you are entitled to receive support and be ready for some amount of stress.

6. There is no guarantee.

Approximately four million children have been born worldwide as a result of in vitro fertilization treatments. It is a highly efficient technology to have a baby when the other treatment modalities are failed. According to statistics, around 85% of pregnancy rate reached after 3 attempts. However, with a good-quality embryo transfer in the best conditions, pregnancy rate is 50-55% per trial. In addition, miscarriage may occur in up to 10-15% in the age of 35. For a young lady trying IVF, take-home baby rate of a single embryo transfer in the optimum conditions for each trial is about 40 % . When much higher figures in the first interview is given to you, you should think about reliability of that centre.

IVF is a highly effective treatment in overcoming many causes of infertility such as low-sperm count, blocked fallopian tubes and PCOS. However, there are no guarantees. In fact, it is known that half of the people who try IVF will not be successful for each trial.

7. When should I give up?

In theory, as long as eggs from woman and the sperm from the man can be obtained and the transfer performed, the couple has a chance of pregnancy. However, if female age is close to 45, with three or more failed attempts, only poor quality embryos hardly obtained despite high-doses of drugs, and you start to get in trouble financially, sit down with your partner and think again.

Should you go on trying even your doctor say so ?

Doctors may be reluctant to stop treatment because they don’t want to accept “failure” on their part as a care-provider or they may feel that part of their job is to remain eternally hopeful and optimistic for you. The bottom line is that this is your and your partners decision.

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  Associate Prof.Dr. Selman Lacin

http://www.turkey-ivf.com