Can fewer hormones be used to stimulate the ovaries for infertility treatment?

This study looked at using clomiphene citrate (Clomid) alone without other hormone therapies to stimulate the ovaries during in vitro fertilization (IVF). It found that this type of IVF with minimal stimulation is an effective treatment for infertility.

IVF is a common infertility treatment in which oocytes (eggs) are removed from a woman’s body, fertilized, and implanted in the uterus. Most IVF procedures use controlled ovarian hyper stimulation (COH). In COH, gonadotropin hormones are used to stimulate a large number of oocytes. However, COH can be physically and mentally stressful. 

An alternate form of IVF uses clomiphene citrate (CC) only. Clomiphene citrate blocks estrogen receptors in the brain, which causes the body to release its own gonadotropins. CC-only IVF was designed to be gentler on patients and result in higher-quality oocytes. However, the effectiveness of CC-only IVF for women with infertility is unclear.

This study followed 834 women who were treated with 2488 IVF cycles. The patients were followed for 5 years or until treatment was discontinued. During each cycle, clomiphene citrate was given to encourage egg development. Ovulation was triggered with buserelin, followed by oocyte retrieval. No gonadotropins were used.

On average, 1.5 oocytes were retrieved from each cycle. The average pregnancy rate per embryo transfer was 35.3%. The average live birth rate per transfer was 27.1%.

Patients’ cumulative live birth rate increased for 5 – 6 cycles, after which there was no additional benefit. The total live birth rate after five cycles was 46.5%. The live birth rates were higher, and miscarriage rates lower, for younger patients. The five-cycle birth rate for women 35 – 37 years was 76.1%. The five-cycle birth rate for women 41 – 42 years was 30.5%.

The study found that clomiphene citrate only IVF is an effective treatment for infertility.

This study does not have a control group, meaning it does not directly compare CC-only IVF to COH IVF. 

Discuss treatment options including IVF with your health care provider.