Cumulative outcomes of minimal stimulation IVF for severe diminished
ovarian reserve women: A retrospective cohort study
Abstract
Objective - To analyze the effectiveness of minimal stimulation
protocol of IVF treatment for patients with severe diminished ovarian
reserve (DOR), especially for whom failed with several cycles of
conventional stimulation IVF protocols previously. Design,
setting and sample – A single center retrospective cohort
study of undergoing IVF during January 1st, 2005 to December 31st, 2021.
A total of 1,111 conventional stimulation cycles and 14,139 cycles of
minimal stimulation IVF cycles were analyzed. Methods - Women
who had undergone minimal stimulation protocol for IVF treatment and who
met the study design were admitted to the study. Patients who met the
study design undergone conventional stimulation IVF cycles were also
included as control. Basic characteristics and clinical outcomes were
all recorded and matched for the analysis of the effectiveness of
minimal stimulation IVF treatment. Main Outcome Measures – The
number of oocytes retrieved, the number of embryos obtained and
gonadotrophin stimulation dosage, stimulation days and clinical
pregnancy rates were analyzed. Results - In 16 years, a total
of 14,139 cycles of minimal stimulation IVF cycles were included into
this study in order to compare the effectiveness of the minimal
stimulation cycles and the conventional stimulation cycles. Although a
smaller number of oocytes was retrieved in the minimal stimulation
cycles compared with the conventional stimulation cycles (1.39 vs 2.26,
p<0.05), the similar pregnancy rates were obtained in both
groups (16.93% vs 18.99%). There were also no differences in live
birth and miscarriage rates in the minimal stimulation cycles compared
with the conventional cycles. Further analysis indicates that the
clinical outcomes were reduced significantly after two cycles of
conventional stimulation cycles with high dosage of gonadotropins in
those women with DOR. Conclusion- Cumulative minimal
stimulation IVF treatment is an effective alternative for women with
severe DOR. If a woman with DOR is seeking fertility treatment, it is
wise to turn to minimal stimulation protocol after no more than two
cycles of the conventional stimulation.