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.