The first ever IVF baby, Louise Brown, was born in 1978 and was conceived without the benefit of any fertility drugs. In the years that followed her birth, the experience of most clinics was that the success of IVF was improved by administering injectable fertility drugs to the woman. Thus, the use of injectable fertility drugs became the routine. One disadvantage of injectable drugs is that they substantially increase the cost of IVF. Not only are the injectable drugs themselves expensive; their use necessitates more office visits and testing in the days preceding oocyte retrieval, and more work for the IVF laboratory personnel after retrieval to care for the resultant greatly increased number of oocytes. To give options to infertile couples who simply cannot afford conventional IVF with injectable drugs, some clinics have continued to offer IVF without injectable drugs, which significantly decreases the total costs of the procedure. It is important to note, though, that not all patients will be candidates for IVF without the use of injectable medication.
There are two slightly different ways in which IVF can be performed without the use of injectable gonadotropins. One is "minimal stimulation IVF," in which the woman takes the relatively inexpensive oral fertility drug clomiphene citrate (Clomid®) early in her cycle with or without several days only of injectable medication. The other way is to take no fertility stimulants whatsoever, and simply aim to retrieve the oocyte produced in the woman's natural cycle. The "take home baby" rate (chance of having a living child) after minimal stimulation IVF is generally believed to be 20-25% percent.
The process of minimal stimulation IVF begins similarly to traditional IVF with treatment with birth control pills in the cycle before stimulation. We will perform a baseline ultrasound around the time of your expected period after the pills. If that ultrasound is normal, you will take clomiphene citrate cycle days three through seven. The next ultrasound will be performed on cycle day eight. Several more ultrasounds will be performed in subsequent days, the exact number and frequency depending on the rate of growth of the oocyte-containing structures (follicles).
The basic techniques of oocyte retrieval, insemination, embryo culture, embryo transfer, progesterone supplementation after embryo transfer, and pregnancy testing after embryo transfer are very similar or identical to those used in conventional IVF-ET and are discussed elsewhere. Not all patients will be candidates for minimal stimulation IVF.
UT Health Fertility Center doctors are also faculty at The University of Texas Health Science Center San Antonio School of Medicine. This allows us to remain one of the most cost-efficient fertility practices in the area. Our staff is happy to answer questions about referrals, itemized diagnostic and treatment costs and billing options. The UT Health Fertility Center participates in a variety of insurance plans. For your convenience, we accept VISA, MasterCard, and Discover.