IVF Babble

Mild treatments in everyday clinic practice

Michalis Kyriakidis, MD, M.Sc., Assisted Reproductive Gynaecologist from Embryolab, talks here about mild IVF treatment and its potential benefits.

It has been almost 40 years since the birth of Louise Brown, the first child born with IVF, and yet the basic principle of treatment remains unchanged even up to now.

Worldwide, the basic effort is to find the optimal way to stimulate the ovaries, to increase the number of oocytes and consequently, the number of embryos a couple ends up with, believing that this will increase their chances of success. This trend, of course, raises several questions. Is the aim of ovarian stimulation just to create as many oocytes as possible? Is there a body strain “cost” associated with ovarian stimulation and if so what is it? Does the increase in the amount of oocytes in a treatment affect the quality of the resulting embryos? And finally, is there a way to individualize a patient’s treatment?

The continuing need for safe treatment schemes has led to the revival of more mild and natural protocols ovarian stimulation.

The term mild stimulation refers to a treatment where smaller doses of drugs are administered, or for a shorter period of time, to collect fewer but better quality oocytes. Mild ovarian stimulation has gained recognition as a safer, less expensive and patient-friendly option. Of course, there is still a tendency of scepticism by the medical community – moreover due to the doubt around its effectiveness.

The basic logic behind mild therapy is that, due to mild stimulation, only the healthiest follicles with the most capable ova will evolve.

Indeed, there is increasing laboratory evidence that mild therapy creates a more natural and friendly environment for the development of the oocytes and consequently the embryos inside the uterus. It also appears that the application of these methods to both good prognostic and low-response patients does not affect the chances of success.

But what are the advantages of mild ovarian stimulation?

The first and perhaps most important advantage is the best safety profile of this treatment. Ovarian hyperstimulation syndrome and multiple pregnancy are the main risks of an in vitro fertilization. So far, our data shows a significantly lower incidence of over-stimulation syndrome in women treated with mild therapy. On the other hand, a selective transfer of one embryo is the most effective strategy to avoid a multiple pregnancy. Indeed, better-quality embryos and a milder endometrium surrounding deriving from a mild ovarian stimulation, can lead to a very successful treatment cycle.

The second benefit of a mild treatment is the best perinatal profile of the babies born and  less emotional and physical pressure on the mother. On the one hand, it seems that the chance of premature labor is significantly reduced in women having undergone a mild treatment, and the final weight of the babies born seems to be better. Additionally, a mild treatment dramatically reduces the psychological anxiety that occurs and makes the process more tolerable and smooth. Finally, the lower cost is an important part of a mild treatment. By avoiding high doses of medication, mild ovarian stimulation may reduce the cost of drug therapy and make treatment accessible even to couples who face difficulties with the financial part of their treatment.

In vitro fertilization with mild ovarian stimulation is the safest, most tolerable, more friendly and cost-effective way to treat.

There are also consistent indications that it is as effective as conventional IVF. It is therefore necessary to consider the benefits of this treatment which can significantly reduce the physical, emotional and financial burden of couples while also promoting a better outcome for both the mother and the child.

To read more on mild IVF or to get in touch with Embryolab, click here

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