Minimal stimulation IVF- MINI IVF TREATMENT:

What is Mini-IVF?

Minimal Stimulation IVF or Mini IVF or Gentle IVF is a special IVF protocol which involves the use of hormone stimulation injections that are of Low dose and fewer number of injections as compared to the standard IVF protocol. It is usually used for IVF for patients who have a low egg count. An increasing number of couples seeking treatment of infertility now-a-days face the challenge of low egg reserve. Let us now understand few basic queries asked by couples seeking IVF treatment by Top IVF specialist of India, Dr Mona Dahiya.

Minimal stimulation IVF or mini IVF is an IVF protocol in which lower doses of injection are used as compared to the conventional IVF protocol. One of India’s Top IVF Doctors, Dr Mona suggests that mini ivf is primarily used in the following 2 broad scenarios.

1. Patients who have a low egg count or a low ovarian reserve / low AMH
2. Patients who are hyper responders and are at a risk of ovarian hyperstimulation syndrome.

The mini IVF protocol or minimal stimulation IVF protocol is a simple protocol or procedure. In the mini IVF protocol, instead of taking the high dose of injections as in normal IVF, low dose injections are used. It involves using combination of

1. Oral medicine
2. Low dose injections for a few days

Most IVF experts in India and across the Globe evaluate the need for mini ivf protocol after a patient history and diagnosis.

Minimal stimulation IVF/Mini IVF Bnefits:

• Reduced medication requirements: Minimal stimulation IVF (MS-IVF), also known as mini-IVF, uses lower doses of medications than traditional IVF, which can lower the cost and potential side effects associated with high doses of fertility drugs.
• Less invasive: Mini-IVF involves fewer injections and monitoring visits than conventional IVF, which can be more convenient for patients with busy schedules or those who are uncomfortable with frequent medical procedures.
• Reduced risk of ovarian hyperstimulation syndrome (OHSS): OHSS is a potential complication of conventional IVF that can cause pain, bloating, and other symptoms. Mini-IVF carries a lower risk of OHSS due to the lower doses of medications used.
• Lower cost: Because Mini-IVF uses fewer medications and requires fewer monitoring visits, it can be a more affordable option for patients who are looking to minimize their out-of-pocket expenses.

Mini IVF Process:

• Ovarian stimulation: The patient takes clomiphene citrate and/or low-dose gonadotropins for several days to stimulate the growth of follicles in the ovaries.
• Monitoring: The patient undergoes ultrasound and/or blood tests to monitor the growth and maturation of the follicles.
• Egg retrieval: Once the follicles have matured, the patient receives an injection of HCG to trigger ovulation. About 36 hours later, the eggs are retrieved from the ovaries.
• Fertilization: The retrieved eggs are fertilized with sperm in the laboratory.
• Embryo transfer: One or more embryos are transferred into the uterus several days after the egg retrieval.

Mini IVF Risks:

• Lower success rates: Mini-IVF has lower success rates than conventional IVF, which may make it a less attractive option for patients who have been unsuccessful with other treatments or who have specific fertility issues.
• Multiple pregnancies: Because Mini-IVF involves the transfer of multiple embryos, there is a higher risk of multiple pregnancies, which can be associated with complications for both the mother and the babies.
• Ectopic pregnancy: Ectopic pregnancy, where the embryo implants outside of the uterus, is a risk associated with all assisted reproductive technologies, including Mini-IVF.

Mini IVF Medications:

• Clomiphene citrate: Clomiphene citrate is an oral medication that is used to stimulate ovulation. It is typically taken for five days during the menstrual cycle, starting on day three or four.
• Low-dose gonadotropins: Gonadotropins are injectable medications that stimulate the ovaries to produce multiple follicles. In Mini-IVF, lower doses of gonadotropins are used than in conventional IVF to reduce the risk of side effects.
• Human chorionic gonadotropin (hCG): hCG is an injectable medication that triggers ovulation after the follicles have reached maturity.

IUI vs. Mini-IVF Treatment:

IUI (intrauterine insemination) involves the insertion of washed and concentrated sperm directly into the uterus during ovulation, while Mini-IVF involves ovarian stimulation and egg retrieval in a laboratory setting.

IUI is typically used for patients with mild male factor infertility or unexplained infertility, while MS-IVF is generally used for patients with more complex infertility issues.

Success rates for Mini-IVF are generally higher than for IUI, but MS-IVF can be more invasive and expensive.

Mini-IVF vs. all other Infertility Treatments:

Compared to other infertility treatments, Mini-IVF has its own advantages and disadvantages:

• Compared to conventional IVF, Mini-IVF uses lower doses of medications and is less invasive, but has lower success rates and may not be suitable for all patients.
• Compared to IUI (intrauterine insemination), Mini-IVF has higher success rates but can be more invasive and expensive.
• Compared to natural cycle IVF, Mini-IVF uses medications to stimulate the ovaries to produce multiple eggs, which can increase the chance of pregnancy but also increase the risk of multiple pregnancies and may not be suitable for patients who want to avoid fertility drugs.
• Compared to donor egg IVF, Mini-IVF uses the patient’s own eggs, which can be more emotionally and financially appealing for some patients but may not be suitable for patients with low ovarian reserve or other issues with egg quality or quantity.

Overall, the choice of infertility treatment depends on the individual patient’s needs and preferences, as well as the recommendations of their fertility specialist.

 

How Many Eggs Are Retrieved in Mini IVF?

In mini-IVF, 2-7 eggs are retrieved. This classification is according to the Rotterdam-based International Society for Mild Approaches in Assisted Reproduction (ISMAAR). Sometimes, with very low egg count there is a possibility that no egg may be retrieved. In standard IVF 8-15 eggs are produced. Since minimal stimulation IVF or mini IVF is done for couples who already have a low egg count/ low AMH, it results in the production of fewer eggs in the range of 2-7. However, some studies have shown that since lower doses of injections have been used, the quality of these eggs is better as compared to when a higher dose of injections is used in the standard IVF. Little Angel IVF has 5 IVF Clinics in India and you can also book an online appointment with infertility expert Dr Mona Dahiya.

Who should consider Mini IVF?

A good candidate for mini IVF is one that qualifies for 1 or more of the following 10 factors that call out the need to undergo mini IVF.

1. Patients with a low egg count who have a low AMH and low ovarian reserve are good candidates for mini IVF.
2. Women over 35 years of age a good candidates for mini IVF.
3. Women with endometriosis should consider mini IVF.
4. A good candidate for mini IVF is a woman with previous ovarian surgery
5. Women with PCOS (polycystic Ovarian Syndrome)
6. Women who are at risk of Ovarian hyperstimulation Syndrome (OHSS)
7. Couples with male infertility with severe oligospermia.
8. Couples looking for Low-Cost IVF treatment.
9. People looking for IVF treatment with minimal use of Injections for stimulation.
10. Couples looking for fewer visits and less monitoring during the IVF Cycle.

In patients with Low AMH, since the baseline number of eggs is low, giving very high dose of injections are not of much benefit. In fact, it only adds to the cost of the IVF cycle. Thus, in such patients, mini IVF may be used. Low-dose injections are given to yield fewer but better-quality eggs. The embryos so formed can be frozen in one cycle. A repeat stimulation may be done in the next cycle to gather more embryos. This is called “embryo pooling “. These are then transferred in a frozen/ fresh cycle. People from across the globe come for ivf treatment in India as the ivf cost in India is among the lowest in the world.

Are Mini IVF worth it?

Mini IVF is worth it as per IVF Expert in India, Dr Mona Dahiya. It is a good IVF protocol for patients who have lesser number of eggs or low AMH. In such patients, this protocol works better. Mini IVF has 5 key advantages as per Dr Mona Dahiya

1. Mini IVF is not a painful process as it requires fewer number of injections.
2. Lower cost on account of Low Dosage Injections makes mini worth it.
3. Minimal Stimulation requires Fewer visits to an infertility Clinic.
4. The Mini IVF treatment process has no or low side effects.
5. Reduced risk of ovarian hyperstimulation is a key advantage of Mini IVF.

Many couples with low AMH have conceived at Little Angel IVF. We assess the couples in detail to formulate an individualised treatment protocol for mild stimulation which helps in getting good quality embryos and a positive result. Little Angel IVF has been constantly rated as the best ivf clinic in India and you can schedule an online appointment to know more.

What is the Mini IVF Success Rate?

Yes, mini IVF is successful. If a proper treatment protocol is formulated, the mini IVF protocol is good for patients with low egg count / low AMH as per world-renowned infertility doctor Dr Dahiya. However, the couple should be counseled about the challenges involved which include the following 3.

1. Cycle cancellation in 10-15 % of patients if improper follicular development.
2. Retrieving no eggs in 5%
3. Having no good quality embryo for transfer despite egg retrieval: 5% of cases

However, we at Little Angel IVF employ close monitoring and intense planning and most of the couples do well and are able to conceive successfully.

What is the difference between IVF and Mini IVF?

The difference between IVF and mini IVF is that in mini IVF lower doses of injections are used to stimulate the ovaries to produce eggs. Also, mini IVF is more advantages as

1. It is less Costly.
2. The number of injections is less.
3. There is less chance of ovarian hyperstimulation and thus it is safer.
4. More patient-friendly.

Mini IVF or “Gentle IVF” is used in patients with a lesser count of eggs. Giving high-dose injections in such cases does not help to improve the number of eggs retrieved. On the contrary, high doses of injections may adversely affect egg quality. Therefore, in such patients, mini IVF is advised. Mini IVF is successful in patients with Low AMH. In such patients, mini IVF is safer and uses fewer injections to yield comparable success rates. The eggs produced are less but they are of higher quality and pregnancy rates of 20-40% have been documented.

Is Mild/Mini IVF better than IVF?

Mild IVF is better in patients with a low egg count or low AMH. In such patient conventional IVF does not help to increase the number of eggs retrieved. Also, conventional IVF uses high doses of injections which do not have much benefit in low egg count patients. Such injections only add to the cost of IVF. In such situations, mini IVF or mild IVF is better.

Mild IVF has the following 10 benefits over IVF:

1. Patient-friendly
2. Safe
3. Low cost
4. Takes less time.
5. Fewer health risks
6. Fewer side effects of injections
7. Low emotional burden or stress
8. Treatment can be repeated sooner
9. Better implantation rates
10. Better quality eggs

What is Mild Stimulation IVF?

Mild Stimulation IVF is a special category of IVF protocol in which instead of giving a high dose of injections, the patient is given a combination of oral medication and low-dose injection for IVF. It is especially useful for patients with low egg reserve or low AMH. This is a more patient-friendly and safer protocol.

What does Mild Stimulation mean?

Mild stimulation means a combination of the following 3 Factors.

1. Number of Injections used to stimulate.
2. Lower dosage of injections used for the stimulation.
3. Fewer Days are required for the Treatment as compared to conventional IVF.

The injections are used along with oral medicines like Clomiphene or Letrozole to produce eggs for IVF. This is a “mild” or “gentle “approach as compared to standard IVF.

What is the difference between Natural and Mini IVF?

The difference between natural and mini IVF is that in natural IVF, no oral medicines or injections are given to produce more eggs. The IVF in Natural IVF is done using a single egg from a lady’s natural menstrual cycle. In mild IVF or Mini IVF, low-dose injections are given to produce more than one egg during IVF. There are around 2-7 eggs in Mini IVF.

 

Natural IVF	Mini IVF
No injections or oral medicines are given	Low-dose injections and oral medicines are given
Only one egg is produced	2-7 eggs are produced.

What are the disadvantages of mini IVF or minimal stimulation IVF?

There are 6 disadvantages of mini IVF or Minimal Stimulation IVF and we are listing down the same for clarity.

1. Fewer eggs are retrieved so a lesser number of embryos formed.
2. The cycle may get canceled in 10-15% of cases if the response to injections is inadequate.
3. At times no good quality embryo may be formed and there is no transfer.
4. The success rate may be lower than standard IVF.
5. There may be no embryos to freeze.
6. If multiple attempts are needed it may become costly.

How Many Days does Mini IVF take?

Mini IVF takes an average of 10 days. Since the Process of egg formation in a woman is spread over 10 to 14 days, the procedure takes nearly 10 days. The procedure starts on the second day of the menstrual cycle when oral medicines are started for egg formation. Additionally, low-dose injections are added and during this time ultrasound is done 3-4 times to see the progress of egg development. You can visit Little Angel IVF, counted among the best ivf centre in India to know more.

 

Mini-IVF FAQs:

Q: What is mini IVF?

A: Mini IVF, also known as minimal stimulation IVF or micro-IVF, is a type of assisted reproductive technology that uses lower doses of fertility drugs and is typically less invasive than conventional IVF.

Q: How is mini IVF different from conventional IVF?

A: Mini IVF uses lower doses of fertility drugs and typically involves fewer monitoring visits and fewer eggs retrieved than conventional IVF. As a result, mini IVF is often less expensive and less invasive than conventional IVF, but it may also have lower success rates.

Q: Is mini IVF right for me?

A: Mini IVF may be a good option for patients who want a less invasive, less expensive approach to fertility treatment, or for patients who are at risk of ovarian hyperstimulation syndrome (OHSS). However, not all patients are good candidates for mini IVF, and the decision to pursue this treatment should be made in consultation with a fertility specialist.

Q: How is mini IVF performed?

A: Mini IVF typically involves using low-dose fertility drugs to stimulate the ovaries to produce fewer eggs than conventional IVF. The eggs are then retrieved and fertilized with sperm in a laboratory, and the resulting embryos are transferred to the uterus for implantation.

Q: What are the success rates for mini IVF?

A: Success rates for mini IVF vary depending on individual factors such as age, overall health, and fertility status. However, studies have shown that mini IVF can have success rates comparable to or only slightly lower than those of conventional IVF.

Q: Does insurance cover mini IVF?

A: Insurance coverage for mini IVF varies depending on the individual insurance policy and provider. Some insurance plans may cover a portion of the cost of mini IVF, while others may not cover it at all.

Q: Are there any risks associated with mini IVF?

A: As with any fertility treatment, there are potential risks associated with mini IVF, including multiple pregnancies, ectopic pregnancy, and ovarian hyperstimulation syndrome (OHSS). However, because mini IVF uses lower doses of fertility drugs, the risks of OHSS and other complications are generally lower than with conventional IVF.

Why You Should consider Little Angel IVF for mini IVF treatment:

 

• Experienced team: Little Angel IVF may have a team of experienced doctors, embryologists, and other staff members who specialize in performing mini IVF procedures.
• Personalized treatment: Little Angel IVF may provide personalized care and treatment plans that are tailored to the specific needs and preferences of each patient, which can help ensure that the mini IVF treatment is optimized for the best possible outcomes.
• Advanced technology: Little Angel IVF may have access to advanced technology and equipment, which can enhance the accuracy and precision of the mini IVF procedure, and potentially improve the chances of success.
• Lower cost: Mini IVF is typically less expensive than conventional IVF, and Little Angel IVF may offer competitive pricing and financing options to help make the treatment more affordable.
• Less invasive: Mini IVF requires fewer fertility drugs and fewer monitoring visits than conventional IVF, which can make it a less invasive and more comfortable option for some patients.
• High success rates: While success rates may vary depending on individual circumstances, Little Angel IVF may have a high success rate for mini IVF, which can be reassuring for patients who are seeking the best possible chances of pregnancy

Dr Mona Dahiya is considered as one of the best ivf doctors in the world and has written various National & International Journals. She is an eminent and infertility Doctor with Fellowship from one of the best infertility hospitals, Singapore General Hospital. She has obtained her medical degrees from the Top medical colleges in India- PG and Residency from Maulana Azad Medical College, Delhi University and MBBS from Lady Hardinge Medical College Delhi University. Dr Mona Dahiya of Little Angel IVF is continuously ranked as the Best IVF Specialist in India. Dr Mona is the founder Director of Little Angel IVF chain of clinics in Delhi, Gurgaon & Noida. Her 3 IVF Clinic in Noida have been voted as the best ivf clinic in Noida for 10 years in a row. With over 20 Years of Global experience and having done more than 3000 IVF Cycles, Little Angel IVF is known for the highest IVF Success rate in India.