Economical IVF with a Simplified Protocol
Dr. Norbert Gleicher explains EcoIVF and CHR’s commitment to quality, affordable care.
Title: EcoIVF at CHR: Economical IVF with a Simplified Protocol
Speaker: Dr. Norbert Gleicher
What is the EcoIVF program? How does it differ from regular IVF cycles performed at CHR?
Our standard EcoIVF program, in contrast to our Eco Donor Egg Program, is a simplified routine IVF cycle. Some of our colleagues call it a ‘mini-IVF cycle’. It is not a concept that we very aggressively are pursuing, and the reason is that, with very few exceptions, we do not think that it is a kind of IVF cycle that makes clinical or economical sense. But there are some very young patients who produce large numbers of eggs and embryos even with very minimal stimulation, who indeed don’t need more, and in those patients it may make sense. But we do not feel that EcoIVF (or ‘mini-IVF’, as others call it) makes sense in older women, so we do not recommend it to women above age 38. We don’t think it makes sense in women with abnormally low ovarian reserve, even at young ages (in other words, women with premature ovarian aging), we we don’t recommend it in them. And therefore, it’s kind of only reserved for the young patient who has perfect ovarian function, may have a tubal problem — in that patient, it may make sense. And it involves a much less aggressive stimulation of their ovaries. Therefore, there’s much less monitoring required, much less medication required. That lowers the cost dramatically, and so once again, we are able to offer this program at very remarkably discounted rates. And the principal idea here, like with our Eco Donor Egg Program, is to make IVF affordable. We feel very bad when we face patients who we know need a treatment and simply cannot get the treatment simply because they cannot afford it, and infertility, unfortunately very often, is not falling under standard insurance coverage, so how much treatment costs is very important. And so our ecoIVF program is geared at giving the opportunity for IVF to patients who simply cannot afford a regular IVF cycle.
Is it true that low-stimulation IVF produces better quality eggs?
No, we don’t think that is true. I mean, to be fair, I have to acknowledge that some colleagues have made that claim — there are even one or two papers in the literature that have suggested this — but we have, first of all, investigated it in our patient population, and we have found it not to be the case. We have done case control studies in our patient population and have not found it to be the case. We have even tested the claim that there are more chromosomal abnormalities in cycles that use more fertility drugs (higher doses of fertility drugs) which in principle is true, but this is, yet again, one example where you really have to be very careful in your statistical analysis, because what we found is that while it is true that the percentage of chromosomal abnormality goes up with increasing dosages of fertility drugs, the number of mature embryos that we end up having for transfer — good embryos that are chromosomally normal — goes up even more. And so while it is true that more medication increases chromosomal abnormality percentages, you still end up with more normal embryos for transfer and therefore with better pregnancy chances if you use higher medication dosages, so we do not believe that mild stimulation, as it is sometimes called, or ‘mini-IVF’, gives you better embryos. It gives you fewer good quality embryos for transfer, and therefore, it reduces your pregnancy chances in comparison to a regular IVF cycle.
- EcoIVF is an economical IVF program that uses simplified protocol, designed specifically for young patients with very good ovarian functions.
- Minimal stimulation IVF cycles (like EcoIVF) do not result in better pregnancy chances via better-quality eggs, despite some specialists making such claims.
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