Modified Natural Cycle for In Vitro Fertilization and Embryo Transfer in Normal Ovarion Responders

Abstract

Controlled ovarian hyperstimulation (COH) using a gonadotrophin-releasing

Ovarian hyperstimulation syndrome: pathophysiology, staging, prediction and prevention

“…Eight studies evaluated milder ovarian stimulation compared to the long‐agonist protocol. Five studies used mild protocols with a GnRH antagonist and hCG triggering, one used clomiphene citrate and hMG, one used hMG only and one used less FSH in an agonist protocol. They all reported OHSS and clinical pregnancy rates; the average rate of OHSS in the control groups was 4.6%.…”

Mild Stimulation versus Conventional IVF: A Cost-Effectiveness Evaluation

“…Although European studies have concluded that mild-IVF was cost-effective over conv-IVF when medications were minimized, no such comparison of mild-IVF and conv-IVF has been undertaken in the United States (US) [16] [19] [20]. As both costs and expected pregnancy rates in the United States are, on average, higher than reported European rates, application of a European assessment on cost-effectiveness is difficult in the US [21]- [23].…”

Mild stimulation for in vitro fertilization

“…A few retrospective non-RCTs showed no cost savings comparing CCþGn cycles with GnRH agonist down-regulation cycles (53,54). However, many RCTs, including the one previously mentioned here, found MS-IVF to be significantly less expensive (22,23,29).…”

“…The systematic review by Matsaseng et al (15) reported a significantly higher CCR with MS-IVF among normal responders (16% vs. 9%; OR 2.55, 95% CI 1.62-4.02). However, many other RCTs, not included in this meta-analysis, found no difference in CCRs when MS-IVF was compared with C-IVF in normal responders (7,23,26,28,29). Interestingly, the Cochrane review that included CCþGn as a ''mild stimulation'' regimen found higher CCR mainly in those RCTs in which a GnRH antagonist was not used to suppress endogenous LH, implying a decline in CCRs with antagonist cotreatment (36).…”