Recently, a
global trend has been witnessed towards adoption of MOS regimes for both IVF
and IUI. MOS-IVF requires smaller doses of hormone for stimulation than a
conventional protocol, making it far less aggressive. Moreover, it has many
other advantages including increased patient preference, decreased cost per
fresh IVF cycle, low possibility of ovarian hyperstimulation syndrome(OHSS),and
better pregnancy outcomes. Both oral and injectableagents can be used for
stimulation since the pituitary is not down-regulated. Oral medications such as
clomiphene citrate, either alone or in combination with gonadotropins have
proved beneficial in women undergoing IVF.
TAKE HOME POINTS
· Ovarian stimulation holds an
important place in the field of assisted reproductive techonologi
· MOS may be a fairly good choice in
certain patients who may fear the adverse effects associated with conventional
controlled ovarian stimulation for IVF
· Mild ovarian stimulation (MOS)
demands only small amounts of gonadotropins, unlike the standard protocol,and
is therefore not as suggestive. This reduces not only patient’s discomfort, but
also drives down the cost of the procedure, making MOS more patient-friendly
· The use of “mild IVF” , in addition
greatly minimizes the risk of OHSS, which is a life-endangering, high-cost
complication of controlled ovarian hyperstimulation
· Clomiphene used in MOS has been shown
to efficiently inhibit luteinizing hormone(LH) surge with fairly good pregnancy
outcomes in women undergoing IVF
· Improved digestive absorption and
consequently better clinical efficacy have been reported with the use of
micronized formulations.
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