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Archive for the ‘Ovarian hyperstimulation syndrome’ tag

Micro-IVF vs. Full Stimulation IVF Study Shows Similar Clinical Outcomes

By Dr. David Kreiner and Tracey Minella

August 21st, 2013 at 7:48 pm

 

photo credit: stockbyte/freedigitalphotos.net

Long Island IVF is excited to offer a glimpse into its fifteen (15) month study of clinical outcomes comparing minimal stimulation IVF (Micro-IVF) and traditional full stimulation IVF.

The two IVF options differ by their stimulation protocols, costs and risks. The fee for basic Micro-IVF is $3900 without anesthesia and not including the medication. In Micro-IVF, patients typically take 100 mg. of Clomid for 5 days, followed by 75 IU of gonadotropin injections for 2-4 days, depending on follicle size as monitored by ultrasound. In full stimulation IVF, patients typically take a GnRH antagonist with doses from 150-600 IU of gonadotropin daily for several days, depending on follicle size as monitored by ultrasound. The amount of medication used, and consequently the number of eggs retrieved, is much greater with the full stimulation IVF.  As a result, generally success rates would be higher with the more aggressive stimulation.

In a retrospective data analysis of patients (<35 years of age) undergoing IVF between October 2011 and December 2012, this study by the physicians and embryologists of Long Island IVF sought to evaluate the effects of minimal stimulation IVF (Micro-IVF) on clinical outcomes. This data was presented at the American Society for Reproductive Medicine (ASRM), held in Boston, Massachusetts on October 17, 2013.

Average Number of Oocytes (Eggs)

Average Number of Embryos Transferred

Fetal Hearts per Embryo Transfer/ (Implantation Rate)

Clinical Pregnancy Rate per Embryo Transfer

Micro-IVF

3.5

1.7

28%

13/28=46%

Full Stim IVF

14.5

1.8

38%

117/215=54%

 

 

In the Micro-IVF cycles, the average number of oocytes (eggs) retrieved was far less than for the full stimulation IVF cycles and therefore there were far fewer embryos to select from for transfer.  As a result, there were most likely fewer high quality pregnancy potential embryos transferred from the Micro-IVF cycles and consequently that implanted (implantation rate).  This did not result in a considerably lower clinical pregnancy rate but there were far fewer twins relative to the group undergoing full stimulation IVF.

Aside from the lower cost, Micro-IVF offers a significantly lower incidence of ovarian hyperstimulation syndrome albeit for most without the advantage of additional cryopreserved embryos.   Even so, with a clinical pregnancy rate of 46% per embryo transfer, the study confirmed that Micro-IVF is often appropriate for younger patients. It can achieve a similar pregnancy rate using fresh embryos, is more cost-effective, and can reduce the risk of hyperstimulation.

 

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Do the results of this study make you more likely to consider Micro-IVF?

If you are interested in Micro-IVF, is it primarily because of the pregnancy rate, the lower risk of ovarian hyperstimulation syndrome, less medication, lower cost, or another reason?

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Don’t Jostle Your Ovaries

By Tracey Minella

February 10th, 2013 at 12:58 pm

It takes a strong woman to go through infertility treatment. And sometimes, in our headstrong, full-speed-ahead-with-blinders-on mode, we feel we’re unstoppable. Invincible, even. But we are not.

With some areas of Long Island blanketed in over two feet of snow, there is a potential danger to infertile women in treatment… snow shoveling. You are not invincible. Do not shovel snow if you are currently in a treatment cycle, have just completed a cycle, are in the two-week waiting period for results, or are pregnant. You must be gentle to and mindful of your ovaries.

When you take injectable medications for IVF (or ovulation induction) to stimulate your ovaries to produce multiple follicles… instead of the single monthly follicle you may otherwise have produced… one of the reasons the doctors monitor you so closely with blood work and sonograms is to reduce the risk of ovarian hyper-stimulation syndrome, or “OHSS”.

When you stimulate the ovaries, they temporarily swell a bit in response, which is expected. OHSS in its mild form can be uncomfortable, but usually resolves on its own. Fortunately, severe OHSS cases are incredibly rare. But in the 1-2% of those cases, patients may experience symptoms including rapid weight gain, abdominal pain, vomiting, and shortness of breath. Pregnancy hormones can worsen OHSS. So, it is important to report any of the above symptoms to your RE as soon as possible, before or after your retrieval or transfer (or IUI). For more info on OHSS, see http://mayocl.in/Xv5NsP

Most women know not to do anything that could be harmful to a developing baby, but they don’t often realize the potential risk certain activities can pose to their stimulated, or recently retrieved, ovaries. Play it safe. Don’t jostle your ovaries.

So put the snow shovel down, ladies. And, leave the vacuum alone while you’re at it, too.

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Have you ever done anything strenuous while stimulating? Have you ever experienced OHSS?

 

Photo credit: Peter Griffin @ http://www.publicdomainpictures.net/view-image.php?image=29815&picture=shovel-snow

 

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Micro-IVF Can Further Reduce Rare Risk of Ovarian Hyperstimulation Syndrome

By David Kreiner MD

July 17th, 2012 at 6:29 pm

Recent media attention* regarding the risk of ovarian hyperstimulation syndrome (OHSS) in in-vitro fertilization (IVF) cases– estimated by most sources at three percent (3%) for patients undergoing traditional IVF — has increased interest in minimal stimulation IVF, also known as Micro-IVF or Mini-IVF.  

Long Island IVF’s Micro-IVF program is five (5) years old and is registered with the Society of Assisted Reproductive Technology separately as East Coast Fertility under the medical directorship of Dr. David Kreiner and embryology directorship of Dr. John Moschella, who have a combined fifty years of IVF experience.

Since the merger of East Coast Fertility with Long Island IVF in October, 2011, the pregnancy rate for women under 35 years of age exceeds 50% per transfer with MicroIVF.  

Using clomid and two days of lowest dose gonadotropin hormones, this minimal stimulation has a 0% incidence of OHSS at Long Island IVF.  

Furthermore, a Micro-IVF procedure costs $3,900.00 plus the cost of the medications, and $500.00 for optional anesthesia.  

In tune with the safer minimal stimulation IVF, Long Island IVF also offers their Single Embryo Transfer (SET) Program to motivate patients to select the very safest procedure by avoiding the increased risk of multiple pregnancyassociated with a multiple embryo transfer.  Patients electing SET for traditional IVF or Micro-IVF pay nothing to freeze excess embryos and store them up to a year.

Certainly those concerned about OHSS, or those looking for a less costly alternative to traditional IVF should inquire about whether Micro-IVF–successfully performed by Long Island IVF’s doctors for five years—might be for them.

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Long Island IVF is holding its annual “Extreme Family-Building Makeover” contest to award a Free basic Micro-IVF cycle, valued at $3,900.00, to a woman without (or who has exhausted) infertility insurance coverage. You do not have to be a LIIVF patient or even a New York resident. Contest ends August 26, 2012. For details, rules, and to enter, click here: http://bit.ly/LHbmQR

Have you experienced severe OHSS during traditional IVF that required hospitalization? If so, did it stop you from pursuing traditional IVF again? Would you consider Micro-IVF?

*This letter was prompted in response to today’s New York Times article, entitled “High Doses of Hormones Faulted in Fertility Care”, by Jacqueline Mroz. See the full article here: http://nyti.ms/OJT4yu

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