Figuring Out if Mini IVF Value Makes It a Good Infertility Treatment for You

This equation helps solve the dilemma about mini IVF value: facts + medical reality + individual preferences = smart decision

Mini IVF is an option to standard in vitro fertilization (IVF) that we offer for some patients but not all. Minimal stimulation IVF also can generate controversy in fertility medicine, with some clinics staying away from it and others offering it.

Why does TRM offer mini? The simple answer is because for some patients it works – or we would have nothing to do with it, I assure you.

Is it for you? We don’t know until we evaluate your fertility. And you won’t know until we’ve done that and then you’ve weighed all the other factors.

Don’t worry, we’ll help you do that, both our physicians and our financial counselors. But we never make infertility treatment decisions for you. Coming to the right conclusion about mini IVF value requires that you calculate like a financial advisor, evaluate evidence like a fertility specialist, and embrace risk like a gambler – all while letting your conscience be your guide.

Sounds like a complicated decision, doesn’t it? Well it can be, and it can also be an easy decision.

Mini IVF value & money

For us, the key money factor isn’t just that mini IVF costs less than standard IVF with a good chance of success for some patients. A big motivating factor for us is that some people who need standard IVF do not have the money to attempt it, while the mini IFV value is an option more likely to be in their budget.

That means mini IVF gives them a chance for a child they wouldn’t otherwise have. That is a powerful reason right there for us to offer mini-IVF.

Dollars and sense of mini IVF value

• Standard IVF generally costs about $17,000 with medications.
• Mini IVF costs around $8,500. The overall cost is less because it involves less medication, less office visits, less time and supplies needed in the embryology lab, and less monitoring.
• In a general sense, since fewer eggs are retrieved in mini-IVF, the odds of having a healthy child are less than with standard IVF, which produces more eggs to work with.
• But you could do two rounds of mini-IVF for about the same cost as one cycle of standard IVF.
• You could also do two or more rounds of mini-IVF and not get pregnant.

Obviously, there are several important what ifs in this list. Otherwise, everyone would choose the less expensive mini-IVF. Every time.

Let’s stow the calculator and pull out the stethoscope.

Mini IVF’s place in the history of fertility medicine

First, let’s remember that sometimes we forget in fertility medicine that the very first IVF baby, and many more who followed, was conceived without any egg stimulation drugs. It was not just mini IVF but natural cycle IVF, which involves no medicines to stimulate egg production and which we also offer.

So mini IVF is not some new concept. But as the Society for Assisted Reproductive Technology points out, fertility specialists quickly learned that including injectable medications in the IVF & embryo transplant process (IVF-ET) improved success rates.

Fast forward to today’s fertility medicine and we see that quite a bit of egg-stimulating drugs are involved in regular IVF. How much of that medicine is the central issue in deciding on the value of mini IVF as a treatment option.

 Learn all about mini IVF

So, who does it make medical sense for?

If a woman has only a few eggs on her ovaries to begin with, due to age or diminished ovarian reserve, the full dose of fertility medications is not going to produce the high number of eggs (10-15) we need in standard IVF. She may do just as well – even better perhaps – with minimal stimulation IVF. We administer a small amount of drugs and she ovulates perhaps two or three eggs.

So a first step is to measure a woman’s ovarian reserve, which is the number and quality of her eggs. But the age of a woman with low ovarian reserve is also a factor.

Look at this study in the American Society for Reproductive Medicine’s journal that reported on a novel mini IVF protocol for poor responders, meaning older women and those with low ovarian reserve. It compared the live baby delivery results of these low responders using mini IVF with the results of women with normal ovarian reserve who underwent standard IVF with its higher medication levels.

• In women under 35 with low ovarian reserve, 50.2% delivered a child undergoing standard IVF, while only 41.2% of those undergoing mini IVF had a child.
• But in women over age 43, the mini IVF group had a birth rate of 22% while the standard IVF group had a 5.5% birth rate.

The study concluded that, “Overall minimal stimulation gave similar results to conventional IVF at half the cost and literally no side effects. For older women and those with very low ovarian reserve, it was actually superior to conventional IVF, and for younger women it was slightly worse.”

We agree. We see pregnancy rates of 40% – 50% with mini IVF in patients who have favorable fertility characteristics. These include:

• Women under 35.
• Those with tubal factor infertility.
• Couples with isolated male infertility.

The overall pregnancy rate for each attempt at standard IVF among all age groups is right at 30%, though this accounts for women and couples of different ages and fertility issues. Women under 35 years old have live birth rates of 55%-60% per standard IVF attempt.

Another big difference between the two is the number of excess embryos: women using standard IVF are more likely to have more embryos than they can use in a single embryo transfer. While women doing mini-IVF also have excess embryos in some cycles, they tend to have less extra embryos and more frequently have no excess embryos.

This means that if their cycle is not successful, they will need to stimulate again rather than go through a frozen embryo transfer cycle. For women who want to have embryos to use now and later for sibling attempts, standard IVF usually offers a better chance at having more embryos to save for additional cycles in the future.

Another medical reason for mini IVF is that some patients cannot tolerate the amount of fertility drugs in standard IVF, and some are prone to ovarian hyperstimulation syndrome (OHSS). Others are conflicted about having too many embryos and deciding how to use those embryos, so they prefer to create less embryos.

Mini IVF value & your druthers

When we place a “value” on something, it is generally never just about money. And that’s the case with mini IVF versus standard IVF. Some things are worth more than money such as peace of mind. Here are other things to consider in the mini IVF value equation.

• Aside from the medical consideration of fertility meds possibly causing OHSS, some couples just don’t want to take drugs if they can help it. This is particularly the case when couples consider using drugs for conception.
• Mini, as the name implies, means less. This carries over to not just medications, which can mean less side effects from them, but to less time involved due to fewer office visits, blood workups and ultrasounds.
• Mini IVF will result in having fewer, if any, embryos to cryopreserve, destroy or donate. This is an important consideration for some patients due to ethical or religious principles. There are also other ways to minimize having too many excess embryos with standard IVF. For instance, we can limit egg fertilization and freeze eggs rather than embryos.

Finally, given all the variables involved, choosing mini IVF is a decision not to be taken lightly. It involves fully understanding all the implications, possibilities and factors related to money, medicine and your preferences. We will help you arrive at the best decision for your situation.