Center for Human Reproduction-New York and the Foundation for Reproductive Medicine, New York, NY, USA.
Reprod Biomed Online. 2012 Apr;24(4):396-402. doi: 10.1016/j.rbmo.2011.12.011. Epub 2012 Jan 8.
Low-intensity IVF (LI-IVF) is rapidly gaining in popularity. Yet studies comparing LI-IVF to standard IVF are lacking. This is a case-control pilot study, reporting on 14 first LI-IVF and 14 standard IVF cycles in women with normal age-specific ovarian reserve under age 38, matched for age, laboratory environment, staff and time of cycle. LI-IVF cycles underwent mild ovarian stimulation, utilizing clomiphene citrate, augmented by low-dose gonadotrophin stimulation. Control patients underwent routine ovarian stimulation. LI-IVF and regular IVF patients were similar in age, body mass index, FSH and anti-Müllerian hormone. Standard IVF utilized more gonadotrophins (P<0.001), yielded more oocytes (P<0.001) and cryopreserved more embryos (P<0.001). With similar embryo numbers transferred, after ethnicity adjustments, standard IVF demonstrated better odds for pregnancy (OR 7.07; P=0.046) and higher cumulative pregnancy rates (63.3% versus 21.4%; OR 6.6; P=0.02). Adjustments for age, ethnicity and diagnosis maintained significance but oocyte adjustment did not. Cost assessments failed to reveal differences between LI-IVF and standard IVF. In this small study, LI-IVF reduced pregnancy chances without demonstrating cost advantages, raising questions about its utility. In the absence of established clinical and/or economic foundations, LI-IVF should be considered an experimental procedure. Low-intensity IVF (LI-IVF) is increasingly propagated as an alternative to standard IVF. LI-IVF has, however, never been properly assessed in comparison to standard IVF. Such a comparison is presented in the format of a small pilot study, matching LI-IVF cycles with regular IVF cycles and comparing outcomes as well as costs. The study suggests that LI-IVF, at least in this setting, is clinically inferior and economically at best similar to standard IVF. LI-IVF should, therefore, as of this point not be offered as routine IVF treatment but only as an experimental procedure.
低强度体外受精（LI-IVF）正在迅速普及。然而，缺乏将 LI-IVF 与标准 IVF 进行比较的研究。这是一项病例对照的初步研究，报告了 14 例年龄在 38 岁以下、卵巢储备正常的女性首次接受 LI-IVF 和 14 例标准 IVF 周期的情况，这些女性在年龄、实验室环境、人员和周期时间方面相匹配。LI-IVF 周期采用低剂量促性腺激素刺激的枸橼酸氯米芬轻度卵巢刺激。对照患者接受常规卵巢刺激。LI-IVF 和常规 IVF 患者的年龄、体重指数、FSH 和抗苗勒管激素相似。标准 IVF 利用了更多的促性腺激素（P<0.001），产生了更多的卵母细胞（P<0.001）并冷冻保存了更多的胚胎（P<0.001）。在进行种族调整后，具有相似胚胎数量转移的情况下，标准 IVF 显示出更好的妊娠几率（OR 7.07；P=0.046）和更高的累积妊娠率（63.3% 与 21.4%；OR 6.6；P=0.02）。调整年龄、种族和诊断后仍然具有统计学意义，但调整卵母细胞后则没有。成本评估未能揭示 LI-IVF 和标准 IVF 之间的差异。在这项小型研究中，LI-IVF 降低了妊娠机会，同时没有显示出成本优势，这引发了对其效用的质疑。在没有既定的临床和/或经济基础的情况下，LI-IVF 应被视为一种实验性程序。低强度体外受精（LI-IVF）作为标准 IVF 的替代方案正在被越来越多地推广。然而，LI-IVF 从未与标准 IVF 进行过适当的比较。在这项小型初步研究中，LI-IVF 周期与常规 IVF 周期相匹配，并比较了结果和成本，从而进行了这种比较。该研究表明，LI-IVF 至少在这种情况下，在临床方面劣于标准 IVF，而在经济方面，与标准 IVF 至少相似。因此，LI-IVF 目前不应作为常规 IVF 治疗方法提供，而只能作为一种实验性程序。
