CRM : Center For Reproductive Medicine

The Center for Reproductive Medicine offers minimal stimulation in vitro fertilization (MS-IVF) and modified natural IVF as cost-effective alternatives to our standard IVF program. In all three types of IVF, egg retrieval and embryo transfer procedures are the same; however, minimal stimulation IVF and modified natural IVF require the use of less fertility medication than their standard counterpart. Modified natural IVF and minimal stimulation IVF allow us to give patients of our Florida fertility center the flexibility to choose a treatment plan that meets their specific needs.

Minimal Stimulation IVF

Standard IVF requires the administration of higher dosages of injectable medications to stimulate the growth of multiple eggs. These medications are expensive and are associated with certain potential health risks. Careful monitoring must be performed to ensure safety and efficacy. While these factors lead to increased costs and time commitment for the patient, the result is an increased number of embryos available for transfer. Also, in standard or traditional IVF, cryopreservation of surplus embryos for transfer in a non-stimulated cycle may be available. The overall expected take-home baby rate with standard IVF varies considerably, based primarily upon the patients’ age.

Minimal stimulation IVF, on the other hand, involves fewer medications. As opposed to the normal ovulatory cycle, in which one follicle matures and is available for release and fertilization, the MS-IVF cycle typically results in the maturation of two to four follicles. With standard IVF, there are an increased number of eggs that are available for transfer.

Candidates for MS-IVF

To be eligible for minimal stimulation IVF, couples must meet at least one of the following criteria:

• Tubal disease: Bilateral tubal occlusion should be proven.
• Endometriosis: Traditional treatments have been unsuccessful.
• Cervical factors / antibody problems: Usual corrective measures have failed.
• Unexplained infertility: Conventional treatments have been unsuccessful.

Other Considerations:

• Patients may not exceed 37 years of age.
• Patients must not weigh more than 200 pounds.
• A hysterosalpingogram (HSG) or hysteroscopy to document normal uterine cavity should be performed within one year of the MS-IVF treatment cycle.
• Severe male factor infertility is not an indication for MS-IVF.

The MS-IVF Process

Minimal stimulation IVF involves the following steps:

• Initial Screening

  During a preliminary consultation with one of our infertility specialists, the various aspects of minimal stimulation IVF are explained in detail, including the risks and complications associated with the procedure. Then, an IVF nurse explains the logistics of the cycle, and blood is drawn from both husband and wife to test for HIV, syphilis, hepatitis B and C, and rubella.  A semen sample is requested at this time, so couples should abstain from sexual relations for two to three days prior to the consultation.

• Monitoring

  On day one, two, or three of your menstrual cycle, an ultrasound appointment is scheduled to check for ovarian cysts and blood is taken to measure FSH and estradiol (E2) levels. Injectable ovulation induction medications (e.g. Bravelle®, Follistim®, Gonal-F®, Menopur®, or Repronex®) are administered.

  Ultrasounds and blood tests to measure estradiol levels are performed to monitor follicular development and to make medication adjustments. A GnRH antagonist (e.g. Antagon® or Cetrotide®) may be administered to help prevent premature ovulation. Once the follicle has reached peak maturity, you will be instructed to take an ovulation-triggering medication called human chorionic gonadotropin, or hCG (Ovidrel®). This injectable medication causes the release of the egg from the follicle approximately 36 to 38 hours after administration.

• Egg Retrieval

  Retrieval of the mature eggs is scheduled for 35 to 36 hours after administration of the hCG. This step of the minimal stimulation IVF process is performed in the office under conscious IV sedation. Under transvaginal ultrasound guidance, a needle is placed into the ovary. One or more eggs may be retrieved. Also on this day, the husband is required to give a semen specimen.

• Embryo Transfer

  After egg retrieval, the egg(s) are incubated for approximately six to eight hours and then inseminated with sperm. Should fertilization take place, embryo transfer is performed approximately three days after egg retrieval. Embryo transfer is a very simple and painless procedure that requires no anesthesia. A small, pliable catheter is passed through the cervix and the embryo is transferred into the uterus. Progesterone support is routinely administered, beginning the day of the egg retrieval and continuing until the results of the pregnancy test are available.

• Pregnancy Test

  Approximately fourteen days after the embryo transfer, a blood pregnancy test is performed. If the test results are positive, a repeat blood pregnancy test is drawn 48 hours later.

Learn More about Your IVF Treatment Options

Modified natural IVF and minimal stimulation IVF are exciting alternatives to standard IVF at our Florida fertility center. Contact the Center for Reproductive Medicine, with offices in Orlando, Celebration, and Lake Mary, to find out if one of these IVF protocols is right for you.