What is a “mini-stim” egg freezing cycle?
A mini-stimulation, or ‘mini-stim cycle’, is a gentler form of egg retrieval that can be performed during the egg freezing process. Instead of using high doses of fertility medications, lower or oral doses are used to help the ovaries produce fewer but good quality eggs. This approach can be ideal for patients who prefer a more natural process, want to lower medication costs, or have a lower ovarian reserve. The goal is to achieve excellent outcomes while keeping treatment as comfortable as possible.
Mini-stim protocols are typically tailored to each patient and often involve a combination of oral medications with or without low doses of injectable gonadotropins. In most cases, the total gonadotropin dose is below 150 units per day, which reduces both medication exposure and overall treatment intensity.
Studies show that although mini-stim cycles generally retrieve fewer eggs, the quality of the eggs is comparable to those from conventional stimulation. For certain patients, this means a gentler process without sacrificing the chance of retrieving healthy eggs.
Who is a candidate for mini-stim?
Mini-stim protocols are not a one-size-fits-all approach, but it can be particularly appropriate for certain groups of patients based on ovarian reserve, past response to fertility treatment, and personal preference.
The number of eggs that can be stimulated during an egg retrieval cycle correlates with the number of eggs a patient has, or their ovarian reserve. Mini-stim protocols may be more appropriate for patients who might be starting off with a lower number of eggs to begin with, as measured during initial testing, since less medication is required to stimulate fewer follicles. Evidence also supports that mini-stim protocols can be especially beneficial for patients who were poor responders to conventional egg retrieval protocols. It can also be a potential choice for those who wish to avoid the intensity of full stimulation or have experienced significant side effects in previous egg retrieval cycles.
How can a mini-stim protocol decrease my risk of OHSS?
A mini-stim protocol naturally lowers the risk of ovarian hyperstimulation syndrome (OHSS) because it uses smaller doses of fertility medication. When the ovaries are stimulated more gently, good-quality eggs can still be obtained while minimizing discomfort, bloating, or fluid retention. This method allows providers to prioritize safety and overall well-being without compromising chances of successfully retrieving eggs.
As with all egg retrieval protocols during the egg freezing process, the choice between mini-stim and conventional stimulation is a deeply personal choice and should be made in partnership with your fertility specialist.
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Dr. Armando Hernandez-Rey is a board-certified reproductive endocrinology and infertility specialist and the founder and medical director of Conceptions Florida. Following his residency in obstetrics and gynecology at the University of Miami-Jackson Memorial Hospital, Dr. Hernandez-Rey completed a three-year fellowship in reproductive endocrinology and infertility at the UMDNJ School of Medicine. He holds three board certifications. He is certified by the American Board of Obstetrics and Gynecology in the subspecialty of reproductive endocrinology and infertility (REI), as well as OB/GYN and Surgery. Dr. Hernandez-Rey is an assistant clinical professor at the Herbert Wertheim College of Medicine at Florida International University and serves as an ad-hoc reviewer for the peer-reviewed journal, Fertility and Sterility.
