Lower doses of IVF drugs?

There have been a number of articles about "mild" or "soft" IVF in the last few months, all suggesting that the higher doses of fertility drugs often used in the UK and USA during fertility treatment are potentially hazardous as they can lead to hyperstimulation. One recent piece described OHSS, or ovarian hyperstimulation syndrome, as a "little-known" side effect of treatment making it sound as if the condition had only just been discovered.   While it may well be little known to the journalist in question, it is hardly little known to anyone who knows much about infertility and treatment.

What's quite interesting about these articles is that they're all entirely one-sided, only quoting experts who happen to be great advocates of mild IVF and making it sound as if anyone who doesn't do this cannot possibly have their patients' best interests at heart.  Such articles would make far more credible reading if they also allowed space for those who don't use mild IVF to explain why.

While it's true that OHSS can be a very dangerous condition, it is also true that some women are at greater risk than others and that careful monitoring during treatment can reduce the chances of the condition developing.  Generally success rates are lower with mild IVF, which is why fertility specialists choose to stimulate the ovaries to produce more eggs in order to increase the chances of success.  Perhaps in the future we will be able to get excellent outcomes with far lower doses of drugs, but in the meantime it may be more prudent to continue to tailor the dose to the individual to increase the chances of success and reduce the risks.

IVF in the news again

Another day, another IVF scare story... or at least that's how it sometimes feels.  We're forever being told that this procedure or that type of treatment is risky for us or our future children.  It's not always easy to make sense of what lies behind the headlines or to decide what might be best for you.

The latest story claims that fertility clinics are putting profits before women's safety by opting for traditional rather than mild IVF, which involves lower doses of drugs.  The safety aspect appears to focus on ovarian hyperstimulation, a condition that occurs if the ovaries become over-stimulated after using fertility drugs. Ovarian hyperstimulation can be very dangerous, but specialists usually have an idea of which women are particularly likely to be at risk before they start treatment and tailor drug doses accordingly.  Once fertility drugs are being administered, regular scans can give an idea of situations where the ovaries are starting to respond too strongly - and in these cases treatment is normally halted, at least for a while.  So yes, of course ovarian hyperstimulation is a risk of fertility treatment, and yes, of course you may want to talk to your fertility specialist about how they ensure the dangers are reduced - but don't be completely panicked by another scare story.

Whatever the rights and wrongs of mild IVF,  today's stories go far beyond that.  One talked about the "toxic" drugs used in fertility treatment in the UK and made it sound as if we use completely different, old-fashioned dangerous drugs here when everyone else in the world is using some kind of safe, modern drug. It's simply not true. Talk to your consultant, talk to your doctor or fertility nurse, talk to your counsellor - then make the decisions that are right for you - and take your daily paper with a pinch of salt!

New approaches to IVF

You may not be aware of the existence of the International Society for Mild Approaches in Assisted Reproduction, or that it held a World Congress on the subject in London a few days ago, but if you've had any personal experience of IVF, you would probably welcome moves to make it an easier treatment.

When you go through an IVF cycle, you can end up feeling like a battery hen as your ovaries are stimulated to churn out more eggs at one go than Nature would deem possible. The doctors and scientists in the International SocIety for Mild Approaches in Assisted Reproduction are advocates of a more gentle approach, which they hope will prove to be just as successful.

Some consultants do offer a form of IVF where you don't take any drugs to stimulate the ovaries, known as natural cycle IVF. Although it has many advantages, it doesn't have particularly high success rates, which often puts people off. Now, more doctors are considering mild, or "soft", IVF where patients are given far lower doses of drugs. There will not be as many eggs, but research presented at the World Congress suggests that the resulting embryos may be better quality, with fewer genetic abnormalities.

This milder approach can cost less as it cuts down on the hefty IVF drugs bill, and it can also be less risky for patients, as it reduces the chances of over-stimulating the ovaries which can be dangerous. IIVF may seem a bit of a sledgehammer treatment for what are often subtle fertility problems, and a milder form of treatment could be the way ahead.