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?