Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- Section III The Best Policy
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- 41A AMH Is a Better Predictor of Ovarian Response Than AFC
- 41B AMH Is a Better Predictor of Ovarian Response Than AFC
- 42A Pituitary Suppression Using GnRH Agonist for IVF Is Outdated
- 42B Pituitary Suppression Using GnRH Agonist for IVF Is Outdated
- 43A The Maximum Effective Dose of FSH for Ovarian Stimulation in IVF Is 300 IU
- 43B The Maximum Effective Dose of FSH for Ovarian Stimulation in IVF Is 300 IU
- 44A There Is No Place for Natural and Mild Stimulation IVF
- 44B There Is No Place for Natural and Mild Stimulation IVF
- Section IX Hormones and the Environment
- Index
- References
44B - There Is No Place for Natural and Mild Stimulation IVF
Against
from Section VIII - Ovarian Stimulation
Published online by Cambridge University Press: 25 November 2021
Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- Section III The Best Policy
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- 41A AMH Is a Better Predictor of Ovarian Response Than AFC
- 41B AMH Is a Better Predictor of Ovarian Response Than AFC
- 42A Pituitary Suppression Using GnRH Agonist for IVF Is Outdated
- 42B Pituitary Suppression Using GnRH Agonist for IVF Is Outdated
- 43A The Maximum Effective Dose of FSH for Ovarian Stimulation in IVF Is 300 IU
- 43B The Maximum Effective Dose of FSH for Ovarian Stimulation in IVF Is 300 IU
- 44A There Is No Place for Natural and Mild Stimulation IVF
- 44B There Is No Place for Natural and Mild Stimulation IVF
- Section IX Hormones and the Environment
- Index
- References
Summary
Optimal IVF entails establishing the balance between safety, oocyte/embryo quality, pregnancy and live birth outcomes, patient views and cost. Conventional ovarian stimulation (cOS) may well result in good outcomes for the majority of couples undergoing IVF. However, for certain cohorts of patients this method may result in suboptimal responses and therefore outcomes. The question is not if natural and mild stimulation (mOS) IVF are better than conventional, but if there is no place for these at all. We should not treat all of our patients the same and must acknowledge that dismissing these protocols from the armoury of our medical practice is a mistake. As will become clear from the debate, the statement that ‘There is no place for natural and mild stimulation IVF’ is simply wrong.
- Type
- Chapter
- Information
- 50 Big Debates in Reproductive Medicine , pp. 230 - 234Publisher: Cambridge University PressPrint publication year: 2021
References
Nargund, G, Fauser, BCJM, Macklon, NS, et al. The ISMAAR proposal on terminology for ovarian stimulation for IVF. Hum Reprod. 2007;22:2801–4.CrossRefGoogle ScholarPubMed
Yeh, JS, Steward, RG, Dude, AM, et al. Pregnancy rates in donor oocyte cycles compared to similar autologous in vitro fertilization cycles: an analysis of 26,457 fresh cycles from the Society for Assisted Reproductive Technology. Fertil Steril. 2014;101:967–73.CrossRefGoogle Scholar
Sunkara, S, La Marca, A, Seed, PT, et al. Increased risk of preterm birth and low birthweight with very high number of oocytes following IVF: an analysis of 65,868 singleton live birth outcomes. Hum Reprod. 2015;30(6):1473–80.CrossRefGoogle ScholarPubMed
Baart, EB, Martini, E, Eijkemans, MJ, et al. Milder ovarian stimulation for in-vitro fertilization reduces aneuploidy in the human preimplantation embryo: a randomized controlled trial. Hum Reprod. 2007;22:980–8.CrossRefGoogle ScholarPubMed
Vermey, BG, Chua, SJ, Zafarmand, MH, et al. Is there an association between oocyte number and embryo quality? A systematic review and meta-analysis. RBMO. 2019;39:751–63.Google Scholar
Polyzos, NP, Drakopoulos, P, Parra, J, et al. Cumulative live birth rates according to the number of oocytes retrieved after the first ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection: a multicenter multinational analysis including ∼15,000 women. Fertil Steril. 2018;110:661–70.CrossRefGoogle Scholar
Smeltzer, S, Acharya, K, Truong, T, et al. Clinical pregnancy (CP) and live birth (LB) increase significantly with each additional fertilized oocyte up to 9 and CP and LB declines after that: an analysis of 15,803 first fresh in vitro fertilization (IVF) cycles from the SART registry. Fertil Steril. 2019;112:520–6.Google Scholar
Lainas, TG, Sfontouris, IA, Venetis, CA, et al. Live birth rates after modified natural cycle compared with high-dose FSH stimulation using GnRH antagonists in poor responders Human Reprod. 2015;30:2321–30.CrossRefGoogle ScholarPubMed
Practice Committee of the American Society for Reproductive Medicine. Comparison of pregnancy rates for poor responders using IVF with mild ovarian stimulation versus conventional IVF: a guideline. Fertil Steril. 2018;109(6):993–9.Google Scholar