Infertility/Fertility/Mini IVF



I d like to know what the "Mini IVF" method is. i read that it has less side effects and less drugs.

I am 38 yrs. female. unable to become pregnant because my husband is sub fertile. he has low sperms count and and not very good quality sperms.

i did and ICSI 6 yrs ago. it was not successful because they did a TESE for my husband and could not find sperms. at that time he had Azoospermia. after that i got OHSS and suffered alot.(Had 22 eggs)

Now after 6 yrs i thought of trying again after taking a break. My husband also was taking some Ayurveda medicine for his infertility issue and now he has a low sperm count.

The Dr i went to recently suggested we try an IUI because i was healthy and my husband had 1.5 ML sperms after sperm wash. it was not successful.

my Dr now has suggested ICSI. i am afraid to do it again because i got OHSS the last time i did it.

I d like to try Mini IVF. i do not know if my Dr will agree to it but i would like your opinion.

I am Sara from Sri Lanka.


Hello Sara from Sri Lanka,

"Mini IVF" is simply using a lower stimulation protocol.  For some clinics this is using a combination protocol with Clomid or Femara plus low dose injectables, and for some clinics it is just using Clomid or Femara.  The goal with mini IVF is to only stimulate a few follicles, but more than the one that you would form naturally.  For example, a mini protocol would try for 5-10 follicles versus full IVF where we try to get 15-20 follicles.

IUI is not a good option based on your age.  At 38 years old, your chances of pregnancy are not much higher than your natural chances so you would have 5% maximum pregnancy rate per month.  IVF with ICSI is definitely the treatment of choice.

In terms of your previous experience in getting OHSS, you need to find a doctor and clinic that is very experienced in stimulating PCOD type patients and have appropriate protocols to prevent OHSS.  Yes, it can be prevented or minimized.  In my practice, I've done hundreds of PCOD patients with only two cases of OHSS over 20 years.  Both patients developed OHSS despite taking all the precautions so they were unusual.  I use a very low dose, step up stimulation protocol with the antagonist and Lupron trigger.  I use a technique called drifting or coasting if needed to minimize the risk.  Finally, in a very few cases, if there has been an overly strong stimulation, I will postpone the transfer and freeze the embryos.  In any case, this is not to boast of myself, but to explain that this can be managed if my a knowledgeable Physician and not something that should prevent you from trying.  Keep in mind that time is working against you.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

for additional information check out my blog at check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  I now provide personalized fee for service consultations/advice/direction via email and payable via Pay Pal.  If interested, contact me via my email at  This service will allow you to have your own personal on-demand infertility expert


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Edward Joseph Ramirez, MD, FACOG


I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.


I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, California Medical Association, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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