April 4, 2012 (New York, NY) —A new study by New York’s Center for Human Reproduction (CHR) has cast doubts on the efficacy of low intensity IVF (LI-IVF) programs, marketed under various names like “mini IVF” and “natural IVF.” According to the study, LI-IVF programs, which utilize lower doses of fertility medications to reduce costs and monitoring visits, do not live up to their proponents’ claims of pregnancy rates comparable to those in conventional low cost IVF.
To evaluate the claims that LI-IVF is more economical and more “patient-friendly,” researchers at CHR matched patients in LI-IVF cycles to comparable patients undergoing traditional IVF cycles. In the resulting study, just published online in the medical journal Reproductive Biomedicine Online1, patients in LI-IVF cycles produced significantly fewer oocytes and embryos, and faced much lower pregnancy rates. Lower pregnancy rates for LI-IVF patients were observed both in initial IVF cycles and cumulatively, taking account of subsequent transfers of cryopreserved embryos.
Most surprisingly, however, when overall costs to achieve a pregnancy were compared, highly touted “cost savings” with LI-IVF were nowhere to be observed. Lower pregnancy rates associated with LI-IVF meant that LI-IVF patients on average needed more cycles to have a take-home baby, which meant the lower per-cycle cost of LI-IVF did not translate into lower cost to achieve a successful pregnancy and delivery. Patients in LI-IVF cycles also took longer to conceive.
“LI-IVF appears to reduce pregnancy chances and prolong time to conception without offering any appreciable compensatory financial benefits,” summarizes Norbert Gleicher, MD, the study’s lead author and medical director of CHR. “When patients started asking for LI-IVF at our center, we, like many other IVF centers, decided to offer the procedure. In contrast to other centers, we, however, explained to our patients that LI-IVF should still be considered ‘experimental’ since no data existed, that compared this method of IVF to standard IVF.”
CHR required that patients sign “experimental” informed consents, and started accumulating outcome data. Dr. Gleicher now notes: “As the result of our study well demonstrates, doing otherwise would have been rather unethical.”
“We must caution patients against resorting to ‘mini IVF’ or ‘natural IVF’ without carefully weighing their options,” warns David Barad, MD, another author of the study and director of clinical ART at CHR. “Until more data becomes available, physicians should offer LI-IVF only as an experimental procedure.”
1Gleicher N et al., A case-control pilot study of low-intensity IVF in good-prognosis patients. Reprod Biomed Online 2012; In press. [Epub ahead of print].
About Center for Human Reproduction
Center for Human Reproduction (CHR, http://www.centerforhumanreprod.com) is a leading fertility center in New York City with a worldwide reputation as a “fertility center of last resort,” offering cutting-edge, research-based treatment options to patients with even the most complex cases of infertility. Dr. Gleicher and Dr. Barad are available for additional comments.