Cutting Edge IVF Procedures

Medical science continues to evolve and discover ever more effective ways to increase the odds of becoming pregnant through InVitro Fertilization (IVF). The result is cutting-edge procedures like “mini-IVF,” which is a milder stimulation protocol. What does it mean for your family building journey? Take a look.

Any egg donor, surrogate, or woman who has experienced IVF will tell you that, by and large, the biggest inconvenience is the stimulation and manipulation of her monthly cycle. These hormonal stimulations have been a necessary part of the IVF process for decades. First doctors trigger a body to create more viable eggs for retrieval, and later to time a cycle and ensure optimal uterine conditions for embryo transfer. Despite necessity, these hormone therapies and frequent injections are stressful. Researchers have been looking into ways to continue to achieve high pregnancy and birth success rates without invasive stimulation cycles since the 1990s.

One of the methods practitioners are moving toward is mild-stimulation. Studies have shown that birth rates are quite similar to more invasive stimulation procedures and resulted in a 70% success rate after three (or fewer) transfers.

Despite the seemingly obvious benefits of fewer medications and similar birthrates, mild stimulation cycles are not without their own drawbacks. In an egg donor or retrieval situation, a lower stimulation protocol can easily result in fewer follicles and the potential need to cancel the procedure. This can lead to a longer time bridge between the start of a program and a live birth for some patients.

Researchers and doctors recommend mild stimulation for patients who are likely to have a poor response to stimulation in the first place. Older patients are a prime example. If the patient is not expected to respond well to the medication in the first place, it seems more conducive to offer a less invasive treatment that may make it easier, both physically and emotionally, to commit to many cycles.

Apart from modifying the stimulation cycles used in IVF, doctors are also beginning to research and understand the idea of uterus transplant in women who have been unsuccessful at getting or staying pregnant. The first uterine transplant happened in 2000, with the first live birth reported in Sweden in 2017. The procedure remains in its infancy and has serious health considerations for both the mother and baby.

As of mid-2017, the uterine removal procedure was reported to take more than 10 hours in surgery, and specialists highly recommend using a live donor. Experts worry that the risk for continued miscarriage, intrauterine growth retardation, preterm delivery, and adverse effects from immunosuppressive therapy may outweigh the potential benefits. At best, they suspect that the patient would be advised to remove the transplanted uterus following the live birth of a fetus.

As medical science continues to open new doors and present new ways to realize parenthood, we stand proudly at the forefront of assisted reproductive therapies (ART) to help create families of choice.

Dr. Kim Bergman

Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for Intended Parents, Surrogates and Donors. She is the co-owner of Fertility Counseling Services and Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the upcoming book, Your Future Family: The Essential Guide to Assisted Reproduction (Conari Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. Her two daughters are in college.