Japanese aka Mini-IVF

Happy Fertile Friday everyone!!

It’s been a while since I’ve posted an update on our journey, mostly because there isn’t too much to say! We have mostly been trying on the idea of pursuing IVF, and while Dave is supportive and I’m coming to terms with that being a necessity, every time I think about who to see and what to do I want to have a panic attack!! It’s so overwhelming – there are so many clinics around our area, a few friends have recommended their doctor as being the best, but it’s just so hard to know. And of course the cost factor is overwhelming. I always said that if we didn’t have a child, I’d throw every last cent we have at it. But the fact is we’re blessed with a beautiful daughter, and I just can’t come to terms with spending $50,000 or more on having another one when that is money that could contribute to her well-being and education.

What we decided to do in the end was to have a consultation with a clinic here in San Diego that does Japanese aka mini- IVF. It’s called Hanabusa Clinic. I wasn’t familiar with it. So what is Japanese IVF?

I’m still in learning stages, but from what I can gather the philosophy of Japanese IVF is based on doing less medication, less stimulation, and aiming for fewer but better quality eggs. It can be called mini-IVF too (short for minimal-stimulation IVF). In mini-IVF there are some stimulating medications given to try to develop 2-3 follicles, but not 6-8 (or more!) as with traditional IVF. The quantities of medications are lower than in traditional IVF, which can be easier on the body to tolerate.

Another difference in mini-IVF is that there is no general anesthesia for egg retrieval, just a local. A thinner catheter is used for the retrieval which minimizes discomfort and side effects.

As Dr Chang at Hanabusa Clinic explained to us, the first egg(s) released during each monthly cycle are typically the best quality anyway, so Japanese IVF focusses on those instead of going for quantity.

The analogy was given to me that more traditional IVF throws lots of drugs at the situation to try to get the maximum number of eggs, and hence the maximum number of embryos to maximize the chance of 1-3 of them ending in a live birth. It’s like throwing tons of fertilizer on the garden and watering the heck out of it to force it to grow. Japanese IVF is more like tending to the garden, giving a bit of water and fertilizer, reassessing and seeing how it’s growing, giving a bit less or a bit more to try to provide it the best environment for it to grow more naturally. That made sense to me.

I’m not saying there’s anything at all wrong with traditional IVF. I will admit that a good part of the reason we’re trying mini-IVF first is because of the cost; it’s also because the rates of success in my age bracket are just as good as for traditional IVF; and finally, because we don’t want several embryos – I’m too old to think about more than one more pregnancy, we don’t particularly want twins or triplets, and our religious beliefs would go against be able to dispose of unused embryos. It just seems to be what’s right for us at this time. If it doesn’t work, we might decide to try traditional IVF next (our doctor at Hanabusa Clinic does that too if that’s what we need). We’re keeping an open mind.

Of course having made the decision and been excited to start, ultrasound showed two ovarian cysts, so we’re hoping that resolves itself naturally this month and we can start next month. The roller-coaster begins!!

So in summary, here are the key features of Japanese IVF (taken from the Hanabusa website)-

• Low medication stimulation protocols
• Egg retrievals that avoid intravenous sedation or general anesthesia
• Using the smallest needle possible to avoid bleeding complications and lowering discomfort after egg retrieval
• Culturing embryos to blastocyst stage to reduce poor quality embryos, failed transfers, and miscarriages
• Possible Embryo freezing if fresh transfer is not ideal
• Vitrification (freezing technique created in Japan) to optimize embryo survival
• Minimal/no medication during embryo transfer
• Single embryo transfer to minimize risk associated with multiple implantations

The main advantages of the minimal stimulation protocols are:

• Fewer daily injections
• Lower costs
• Fewer days of monitoring
• Less discomfort
• Reduction of ovarian hyperstimulation syndrome
• Minimizing the risk of ovarian and endometrial cancer

As always I’ll keep you posted as I learn more. I think this could be a good middle ground for a fair number of women, especially those who don’t want to take a whole lot of medication, those who are concerned about the cost of IVF, and those who are only wanting one child/ pregnancy.