Picture: Twins 
Multiple births occur less often
with mild in-vitro fertilisation
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Whereas in mild in-vitro fertilisation (IVF) only a mild ovarian stimulation with gonadotropin-releasing hormone (GnRH) antagonist is combined with single embryo transfer, in a standard IVF a stimulation with GnRH antagonist long-protocol is combined with the transfer of two embryos. A mild IVF is not only as successful as the standard procedure, it can also reduce patients' discomfort, multiple pregnancies, and costs, according to an Article published in The Lancet.

IVF is a complex treatment for infertility that entails costly regimes for ovarian stimulation, serious discomfort to patients, and substantial risks of complications. Strategies with shorter ovarian stimulation protocols—such as GnRH antagonist cotreatment—and transfer of a single embryo could allow more IVF cycles in the same period as conventional treatment, and produce a similar proportion of livebirths. Moreover, such mild strategies could reduce patients' discomfort and diminish the costs associated with multiple pregnancies.

Bart Fauser (University Medical Centre, Utrecht, Netherlands) and colleagues did a randomised trial to compare mild IVF treatment with standard IVF treatment in 404 patients. The 1-year cumulative proportion of pregnancies leading to livebirths was much the same with a mild strategy of IVF (43.4%) as with the standard IVF strategy (44.7%).

The proportion of couples with multiple pregnancy outcomes was 0.5% with mild treatment versus 13.1% with standard treatment, and mean costs were €8333 and €10745 respectively. There were no significant differences between the groups in the anxiety, depression, physical discomfort, or sleep quality of the mother. The authors conclude: "Our findings should encourage more widespread use of mild ovarian stimulation and single embryo transfer in clinical practice."

MEDICA.de; Source: Lancet