Mild Ovarian Stimulation with Clomiphene Citrate Launch is a Realistic Option for in Vitro Fertilization

Objective: To validate the use of clomiphene citrate in IVF when mild stimulation approaches are chosen to reduce patient discomfort, risk, and cost.

Design: Prospective cohort study.

Setting: Private IVF clinic.

Patient(s): A total of 163 patients undergoing IVF and with a good prognosis (defined as ≤38 years old with normal ovarian reserve and normovulatory cycles, body mass index <29 kg/m(2), no previous assisted reproductive technology cycles, no severe endometriosis, no history of recurrent miscarriage, no endocrine/autoimmune diseases, and no surgical semen extraction).

Intervention(s): Mild stimulation using a fixed protocol of clomiphene citrate (100 mg/d from cycle days 3 to 7) in combination with low doses of gonadotropins (150 IU of recombinant FSH on cycle days 5, 7, and 9) and GnRH antagonist.

Main Outcome Measure(s): The cumulative delivery rate per patient after three fresh and/or frozen embryo transfers and time to pregnancy.

Result(s): No dropouts were observed. The cumulative delivery rate was 70%, and the mean time to pregnancy was 2.4 months.

Conclusion(s): Mild stimulation using clomiphene citrate in combination with low doses of gonadotropins can be considered a realistic option for good-prognosis patients undergoing IVF.