Natural & Mini Stim IVF
We offer lower cost alternatives to Standard IVF: Natural IVF and Mini Stim IVF . Instead of aggressively stimulating the ovaries with high dose medication and then doing an egg retrieval, we can use one of these methods to achieve similar outcomes at a lower cost.
At a Glance
- Low doses of medication and minimal monitoring make it less stressful
- Egg retrievals require no anesthesia
- Preimplantation Genetic Testing (embryo biopsy for genetic analysis) is discounted with our 3-cycle package price
- ICSI is included when male factor infertility is a factor
Both Natural IVF and Mini Stim IVF can produce the same number of pregnancies as a single cycle of conventional IVF.
Natural IVF got its start because women didn’t like all of the injections required for conventional IVF. Doctors in Japan sought alternate ways to help these women conceive. Since then, Natural IVF has morphed into a very effective way to achieve excellent outcomes without medications pushing a woman’s ovaries to their max.
Through the years, it has been discovered that “more is not always better,” and this is the case for Mini Stim IVF. Conventional IVF can produce a larger quantity of eggs; the embryos that develop generally come from the best of the eggs, while the remaining eggs have lower potential. Mini Stim IVF is a hybrid of Natural IVF and conventional IVF. We use medications to stimulate follicle and egg production, but at very low doses. A lower number of follicles develop, meaning that we retrieve fewer—but often higher quality—eggs.
With conventional IVF, about a third of the cost is for the medications. With Natural IVF and Mini Stim IVF, fewer (or no) medications means far more cost-effective treatment.
How Natural IVF Works
With conventional IVF, the ovaries are vigorously stimulated prior to doing an egg retrieval. We can achieve the same outcome—at lower cost—by doing up to three cycles of Natural IVF. We use a tiny needle to retrieve the eggs you produce normally during your menstrual cycle. The procedure is very quick, and patients tolerate it well. Anesthesia is typically not necessary but is available for an additional fee for those who request it.
Once the eggs are retrieved, we follow conventional IVF laboratory procedures. The eggs and sperm are placed together to facilitate fertilization. In cases of male factor infertility, we use intracytoplasmic sperm injection (ICSI) to inject the sperm directly into the egg to encourage penetration and fertilization. After fertilization, embryos start to develop. Five days later, if an embryo develops to the 80 to 100-cell stage (called a ‘blastocyst’), it can be biopsied for genetic analysis, and then frozen for transfer.
Once we’ve obtained one or two chromosomally normal (euploid) embryos, we can perform the transfer with estrogen and progesterone medication, just as we would with a conventional IVF frozen embryo transfer.
How Mini Stim IVF Works
Mini Stim IVF is a hybrid of Natural IVF and conventional IVF, with lower doses of oral and injectable drugs, and minimal monitoring. In this approach a modest number of follicles develop. Once the follicles develop, the process continues in the same manner as conventional IVF or Natural IVF.
THE MINI STIM IVF PROCEDURE
You will stop your birth control pills on a Sunday. On day #6 or #7 you’ll begin taking oral clomiphene and continue it every day until you are ready for the trigger drug. Clomiphene stimulates the ovaries to produce a small number of follicles. In the prolonged administration mode, it suppresses the premature release of luteinizing hormone (LH), which keeps you from ovulating before we are ready. In some cases, we’ll add a low dose of injectable gonadotropin for a few days to help with stimulation.
When the follicles are the proper size, somewhere between 18 and 24 mm for the largest follicles, we do the trigger shot to encourage your ovary to mature and release an egg.
Natural & Mini Stim IVF Candidates
You may be a good candidate for Natural IVF or Mini Stim IVF if you:
- have been told the only way you will conceive is with an egg donor
- have diminished ovarian reserve (DOR)
- do not want multiple surplus embryos after conceiving
- do not tolerate the injectable medications
- are looking for a low-cost option
- have PCOS
- do not have fallopian tubes
- want a more natural approach to conceiving
- are interested in preimplantation genetic screening (PGT)
No one is excluded from this program due to age, Anti-Mullerian Hormone (AMH), or past history. Patients who have poor prognosis do have the option egg donation. However, if you choose to pursue IVF, Mini Stim IVF is more cost effective than conventional IVF. Conventional IVF involves injectable medications such as gonadotropin, which are expensive and often prove ineffective for this patient population.
As women age, both the quality and the quantity of their eggs decreases. Physicians often advise patients over 40 who fail IVF to stop trying to use their own eggs and to use an egg donor, which offers 60% to 80% success. However, not everyone is ready to make that leap. While using an egg donor is a wonderful solution, if you feel strongly about continuing to try with your own eggs, persistence is key.
Diminished Ovarian Reserve
Diminished ovarian reserve (DOR) means that the ovary has lost its normal reproductive potential, compromising fertility. This is most often the result of normal aging, but can affect younger women, typically the result of disease or injury. In fact, similar to women in their mid-40s, younger women with DOR find that as few as 10% of their eggs, and the resulting embryos, are chromosomally normal (euploid).
The goal of conventional IVF is to stimulate the follicles by using a high dose of injected gonadotropins (FSH). Because women with DOR already have elevated FSH levels, the stimulation does not produce more eggs. In addition, stimulation can affect the quality of her eggs. After spending thousands on IVF, many DOR patients’ cycles will be cancelled due to poor response.
For women with DOR, Natural and Mini Stim IVF offer a better chance of success. Most patients choose our 3-cycle package. For three consecutive months, we retrieve an egg naturally and fertilize it in the lab. We can then biopsy and freeze all resulting embryos. In month four, we perform the transfer. The good news is that, once we have a normal embryo, a woman in her mid-40s has nearly as good a chance for a normal pregnancy as a 30-year-old. The best part is drastic stress reduction because life is not consumed by an overwhelming schedule of injections and monitoring.
Mini Stim IVF vs Conventional IVF
With conventional IVF, most women find these three elements most taxing:
- Time – the sheer volume of tests, ultrasounds, doctor's visits, and waiting room time
- Money - the procedures and the drugs add up considerably
- Stress - intense treatment cycles that can take over your life
Much of this stress goes unresolved when patients do not conceive. Due to the high cost, it is often impractical to continue conventional IVF. Mini Stim IVF is less taxing in each of these areas and gives hope to patients who need to persist.
If you have tried conventional IVF, Mini Stim IVF may seem counterintuitive. You have always been told that the goal is to get as many eggs as possible. Natural IVF and Mini Stim IVF offer a way to keep trying, at a lower cost. Both procedures yield fewer, but often higher quality eggs. The journey is easier too: typically, there is one mid-cycle ultrasound, and the trigger date can be set. Egg retrieval requires no anesthesia, so you’ll walk into the procedure fully alert. After just a few minutes of discomfort, you are free to go about your day. No recovery time, no need to have somebody drive you home. You can even go right back to work.
A unique feature of both Natural IVF and Mini Stim IVF is the recommended use of preimplantation genetic testing (PGT-A). By analyzing the chromosomes in each embryo, we transfer only those that are chromosomally normal (euploid), improving the chances of a successful pregnancy.
PGT-A is offered at a discounted price with our 3-cycle packages.