Mini IVF or Modified Natural cycle by using minimum no of gonadotrophins and Antagonists

 The use of the natural cycle for IVF offers the advantage of a patient-friendly and low-risk protocol. Its effectiveness is limited, but may be improved by using a GnRH antagonist to prevent untimely LH surges .Natural cycles were abandoned in in-vitro fertilization (IVF) embryo transfer, due to premature luteinizing hormone (LH) surges–and subsequent high cancellation rates. But the  administration of a gonadotrophin-releasing hormone antagonist (Cetrorelix) in the late follicular phase of natural cycles in patients undergoing IVF and intracytoplasmic sperm injection (ICSI) can obviate premature LH rise . Cycles were monitored, starting on day 8 by daily ultrasound and measurement of serum concentrations of oestradiol, LH, follicle stimulating hormone (FSH) and progesterone.

 

What are the conditions when one should administer antagonist?? Ans;  When plasma oestradiol concentrations reached 100–150 pg/ml, with a lead follicle between 12–14 mm diameter, a single injection (s.c.) of 0.5 mg or 1 mg Cetrorelix was administered.

Human menopausal gonadotrophin (HMG; 150 IU) was administered daily at the time of the first injection of Cetrorelix, and repeated thereafter until human chorionic gonadotrophin (HCG) administration.

 No decline in follicular growth or oestradiol secretion was observed after Cetrorelix administration. Therefore Cetrorelix in single dose administration could represent a first-choice IVF treatment with none of the complications and risks of current controlled ovarian hyperstimulation protocols, and an acceptable success rate. Due to the low-risk and patient-friendly nature of the MNC (modified Natural Cycle ) protocol, it seems a feasible treatment option for patients requiring IVF