The minimal stimulation protocols for DOR
Mild/minimal stimulation protocols have been implemented to be offered
to sub-fertile patients who respond poorly to ovarian stimulation or
suffer from DOR. Mild/minimal stimulation protocols using low doses of
gonadotrophins have been implemented in clinical practice, demonstrating
significant advantages, including cost effectiveness. Currently, most
opposing opinions for minimal stimulating protocol were based on its
longer time to achieve pregnancy, its higher cancellation rate and its
lower pregnancy rate. However, in a DOR setting, the cancellation rate
is high regardless of the stimulation protocol. In these women, based on
our “waiting for a good oocyte” strategy, the rationale of
mild/minimal stimulation is that its benefits through lower
gonadotrophin doses, the lower costs that accompanies the treatment,
together with its equality in terms of effectiveness to the
conventionally used protocols for ovarian stimulation. If patients with
DOR just spend 1/10 of money to obtain the same 1-2 oocyte comparing
with hyper-stimulation protocol, why not?