Fertil Steril. 2016 May;105(5) – 2016-05-15
Richard J. Paulsona, Bart C. J. M. Fauserb, Lan T. N. Vuongc, and Kevin Doodyd
Published: April 04, 2016
Author information
a USC Fertility, University of Southern California, Los Angeles, California;
b Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands;
c Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam;
d Center for Assisted Reproduction, Bedford, Texas
Abstract
One of the barriers to access to fertility care is the relative complexity of fertility treatments. If these can be simplified, more patients may be able to take advantage of these treatments. In this overview, we review the potential benefits of simplifying ovarian stimulation by the means of four distinct methods: 1) using mild stimulation for IVF cycles; 2) using in vitro maturation to allow for the retrieval of oocytes that are not yet fully mature yet have the potential to result in live births; 3) conducting IVF in modified natural cycles which use no exogenous FSH stimulation; and 4) allowing embryo culture to take place in a novel intravaginal incubation system. These methods are considered to be somewhat unconventional, yet they have all been shown to lead to live births. In the era of individualized patient care, these techniques present viable alternatives to standard treatment. As experience and outcome data accumulate, they may prove to be not just alternatives to standard treatment, but potentially first-line treatment choices.
KEYWORDS:
ART, Mild stimulation, IVM, natural cycle IVF, intravaginal culture