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.