A NOVEL OVARIAN STIMULATION PROTOCOL FOR USE WITH THE ASSISTED REPRODUCTIVE TECHNOLOGIES

Objective: To determine whether a new ovarian stimulation protocol ter med ''minimal stimulation'' provides pregnancy rates (PRs) comparable with those in a conventional full stimulation protocol for patients un dergoing assisted reproductive technologies (ART). Design: Prospective , nonrandomized study of patients in minimal stimulation or full stimu lation, followed by standard IVF and zygote intrafallopian transfer or uterine-ET. Setting: The ART program of the Mayo Clinic, Rochester, M innesota. Patients: Women (n = 120) 42 years of age or younger with se rum day 3 FSH level less-than-or-equal-to 15.0 mIU/mL (conversion fact or to SI unit, 1.0), normal thyroid-stimulating hormone and PRL levels , normal endometrial cavity as observed on hysterosalpingogram, and pa rtners with a normal semen analysis. Interventions: Oral clomiphene ci trate, hMG, oocyte retrieval, IVF-ET. Main Outcome Measures: Cancellat ions, implantation, pregnancy. Results: The cancellation rate was not significantly higher in minimal stimulation (25.8%) than in full stimu lation (14.1%). Minimal stimulation cycles yielded fewer oocytes per a spiration (3.4 +/- 1.6) than full stimulation (10.1 +/- 5.4). There wa s no difference in the implantation rates per ET (minimal stimulation, 16.4%; full stimulation, 13.3%) or overall clinical PRs per retrieval (minimal stimulation, 31%; full stimulation, 42%). Conclusions: Minim al stimulation for IVF is less expensive than full stimulation and min imizes monitoring and patient discomfort. In addition, it produces acc eptable PRs and represents an attractive alternative to select patient s undergoing ART.