The Hidden Challenge of Minimal Stimulation IVF: Understanding Attrition in the IVF Process
Dr. Kelly Caperton • September 18, 2025
Exploring the Role of Attrition in IVF and Its Impact on Success Rates
When patients begin exploring fertility treatment options, many are drawn to the idea of minimal stimulation IVF—sometimes referred to as “mini-IVF.” This approach uses lower doses of fertility medications to stimulate the ovaries, making it appealing to patients who are hoping for:
- Lower treatment costs
- Reduced medication use
- A “gentler” IVF cycle
However, while mini-IVF may sound attractive, it comes with important limitations. At Caperton Fertility Institute, with fertility clinics in Albuquerque, NM, and El Paso, TX, we want to help patients understand one of the biggest challenges in IVF—attrition—and why minimal stimulation may not provide the best chance of success for many individuals or couples.
What Is Attrition in IVF?
Attrition refers to the natural decline in egg and embryo numbers that occurs at each step of the IVF process. Even in ideal scenarios, not every egg will develop into a healthy embryo ready for transfer. Here’s how attrition typically happens:
- Egg Retrieval – Not every follicle produces a mature, healthy egg.
- Fertilization – Not every egg fertilizes normally.
- Embryo Development – Some embryos stop growing before reaching the blastocyst stage.
- Genetic Testing (if performed) – Some embryos are chromosomally abnormal.
- Embryo Transfer – Not every embryo transferred results in a pregnancy.
Because attrition occurs at every stage, starting with more eggs gives patients a higher chance of ending with at least one healthy embryo to transfer.
Why Minimal Stimulation IVF Can Be Limiting
In a conventional IVF cycle, higher doses of medication are used to stimulate the ovaries, producing a larger number of eggs. In contrast, minimal stimulation IVF typically results in only 2–5 eggs.
Here’s the challenge: with such a small starting number, attrition can leave patients with no embryos to transfer.
For example:
- 4 eggs are retrieved → 3 are mature
- Of those, 2 fertilize
- After several days, 1 develops into a blastocyst
- If that embryo is abnormal or fails to implant, the cycle ends without a pregnancy
While it is possible to achieve success with mini-IVF, the risk of ending a cycle without embryos is significantly higher compared to conventional IVF.
The Caperton Fertility Institute Perspective
At Caperton Fertility Institute, our philosophy is to maximize your chances of success while being transparent about the realities of fertility treatment.
While minimal stimulation IVF may seem less invasive, the trade-off is often:
- Fewer eggs
- Fewer embryos
- Lower success rates due to attrition
With advanced fertility care in Albuquerque, NM, and El Paso, TX, we carefully review every patient’s medical history, fertility testing, and personal goals to recommend the most effective treatment plan.
We believe that understanding the impact of attrition empowers patients to make informed choices about their fertility journey.
Final Thoughts: Is Mini-IVF Right for You?
While minimal stimulation IVF may sound appealing, it is not always the best choice for patients who want the highest chance of success per cycle. Understanding the role of attrition in IVF helps explain why starting with more eggs—and ultimately more embryos—leads to better outcomes.
If you are considering IVF and wondering whether mini-IVF or conventional IVF is right for you, our team is here to guide you.
📍 Caperton Fertility Institute – Albuquerque, NM & El Paso, TX
📞 Call us today or request your appointment online to begin building the family of your dreams.
Weight plays a critical role in reproductive health . Both overweight and underweight individuals may face challenges when trying to conceive, but for many patients struggling with obesity, even modest weight loss can significantly improve fertility outcomes. At Caperton Fertility Institute , with clinics in Albuquerque, NM, and El Paso, TX , we recognize the potential of new weight-loss therapies—such as GLP-1 receptor agonists—to support fertility and reproductive goals. How Weight Affects Fertility Excess body weight can affect fertility in multiple ways: Hormonal Imbalances – Obesity can disrupt the hypothalamic-pituitary-ovarian axis , leading to irregular menstrual cycles and ovulation problems. Insulin Resistance – Common in individuals with a higher BMI, insulin resistance can interfere with ovulation and increase the risk of polycystic ovary syndrome (PCOS) . Inflammation – Excess fat tissue produces inflammatory markers that may reduce egg quality, embryo development, and implantation success . Male Fertility – Elevated BMI in men is linked to lower testosterone, reduced sperm quality, and decreased libido. 👉 Even a 5–10% reduction in body weight can restore ovulation and improve the chances of natural conception or success with fertility treatments like IUI and IVF . What Are GLP-1 Agonists? GLP-1 (glucagon-like peptide-1) receptor agonists are a class of medications originally developed to treat type 2 diabetes. They mimic the natural GLP-1 hormone, which helps regulate blood sugar and appetite. Common GLP-1 medications include: Semaglutide (Ozempic®, Wegovy®) Liraglutide (Saxenda®) These medications have shown remarkable weight loss results in people with and without diabetes, making them a valuable tool for patients preparing for pregnancy. Benefits of GLP-1 Agonists for Fertility For patients struggling with obesity or PCOS, GLP-1 medications may support fertility by: Promoting sustainable weight loss Improving insulin sensitivity Helping regulate menstrual cycles Reducing symptoms of PCOS Lowering systemic inflammation As part of a preconception health plan , GLP-1 therapy may help create a healthier environment for conception and pregnancy. Considerations for Using GLP-1 Agonists in Fertility Treatment It’s important to use GLP-1 medications under the guidance of a fertility specialist . Key considerations include: Timing – GLP-1 agonists should generally be discontinued before trying to conceive , since safety in pregnancy has not yet been fully established. Medical Supervision – Safe and effective use requires oversight, often in combination with nutrition counseling and lifestyle changes . Individualized Plans – Not every patient is an ideal candidate. A comprehensive metabolic and fertility evaluation can help determine the best course of action. Weight Loss as a Path to Parenthood Weight loss isn’t just about numbers on the scale—it’s about optimizing your body for a healthy pregnancy . At Caperton Fertility Institute , we believe in a holistic, evidence-based approach to weight and fertility, combining: Advanced reproductive technologies (IUI, IVF, egg freezing) Metabolic health strategies The latest innovations like GLP-1 therapies Together, these tools can help patients achieve better fertility outcomes and increase their chances of bringing home a healthy baby. Next Steps: GLP-1 Agonists and Fertility Support If you are struggling with weight and fertility challenges or are interested in learning whether GLP-1 medications (Ozempic®, Wegovy®, Saxenda®) could play a role in your fertility journey, our team is here to help. 📍 Caperton Fertility Institute – Albuquerque, NM & El Paso, TX 📞 Call today or request your consultation online to explore personalized fertility solutions tailored to your health and family goals.
At Caperton Fertility Institute , our team is dedicated to offering patients the latest advances in reproductive medicine. One of the most promising emerging treatments we are exploring is intra-ovarian platelet-rich plasma (PRP) therapy , sometimes referred to as ovarian rejuvenation . This innovative approach may provide new hope for women facing diminished ovarian reserve or early ovarian aging , helping them regain options on their fertility journey. What Is Platelet-Rich Plasma (PRP)? Platelet-rich plasma (PRP) is a concentrate of platelets derived from a patient’s own blood. Platelets are naturally rich in growth factors —proteins that stimulate healing, repair, and regeneration of tissue. PRP has been widely used in: Orthopedics (joint healing, tissue repair) Dermatology (skin regeneration) Sports medicine (injury recovery) Now, these same regenerative principles are being applied in reproductive medicine to support ovarian health. How Does Intra-Ovarian PRP Work? The intra-ovarian PRP procedure involves: Drawing a small blood sample from the patient Processing the blood to isolate PRP Carefully injecting PRP into the ovaries using ultrasound guidance Potential benefits of ovarian PRP may include: Stimulating dormant ovarian follicles Improving blood flow within the ovary Supporting development of higher-quality eggs Potentially restoring hormone production in women with early ovarian decline While PRP is still considered experimental , initial studies and clinical reports show encouraging signs that it may improve ovarian function in select patients. Who Might Benefit From Ovarian PRP? Ovarian PRP therapy may be considered for women with: Diminished ovarian reserve (low AMH or high FSH levels) Premature ovarian insufficiency (POI) or early menopause A poor response to IVF stimulation in the past Age-related decline in ovarian function and delayed fertility goals ⚠️ Important Note: PRP is not a cure for infertility, and not every patient is an ideal candidate. At Caperton Fertility Institute, we take a highly individualized approach to determine if PRP could be beneficial for your unique situation. What Does the Research Say About Ovarian PRP? The use of intra-ovarian PRP is still investigational, and more large-scale clinical trials are needed. However, early studies suggest some women may experience: Improved hormone levels (FSH, AMH, estrogen) Return of menstrual cycles in cases of ovarian insufficiency Increased number of eggs retrieved during IVF cycles These findings provide hope, but it is essential to set realistic expectations . PRP is not yet a standard fertility treatment, and outcomes vary from patient to patient. The Caperton Fertility Institute Approach At Caperton Fertility Institute in Albuquerque, NM, and El Paso, TX , we are committed to bringing safe, evidence-based innovations to our patients. For women exploring ovarian rejuvenation with PRP , we offer: Compassionate counseling Thorough fertility evaluation Access to emerging therapies within the context of advanced fertility care Our goal is to maximize your chances of success—whether that involves IVF, egg freezing, or ovarian PRP therapy . Is Ovarian PRP Right for You? If you are struggling with: Diminished ovarian reserve Premature ovarian insufficiency (POI) Past IVF challenges or poor ovarian response …then ovarian PRP may be worth discussing with your fertility specialist. Every patient’s fertility journey is unique, and our team is here to help you explore your best options with clarity and hope . Next Steps At Caperton Fertility Institute , we combine cutting-edge science with compassionate care . If you are interested in learning more about ovarian rejuvenation with PRP or other fertility treatments, we invite you to schedule a consultation today. 📍 Locations in Albuquerque, NM, and El Paso, TX 📞 Call us now or request an appointment online to explore whether ovarian PRP therapy could be part of your fertility plan.
One of the most challenging moments in IVF treatment is when a healthy embryo is transferred into the uterus, but implantation does not occur. At Caperton Fertility Institute , we understand how frustrating and disheartening this can be. That’s why our team is exploring promising new therapies designed to improve endometrial receptivity and support successful embryo implantation. Among the most exciting innovations are: Intrauterine Platelet-Rich Plasma (PRP) Intrauterine Human Chorionic Gonadotropin (hCG) Peripheral Blood Mononuclear Cells (PBMCs) Each of these investigational treatments may help prepare the uterine environment to better support embryo implantation, especially for women who have experienced repeated implantation failure (RIF) . Intrauterine Platelet-Rich Plasma (PRP) Just as PRP has been studied for its regenerative potential in ovarian health, it may also improve the uterine lining (endometrium). PRP is prepared from a patient’s own blood and infused into the uterine cavity before embryo transfer. Potential benefits of intrauterine PRP for implantation include: Promoting growth of the endometrial lining Enhancing blood flow to the uterus Stimulating growth factors that may improve embryo receptivity For women with thin endometrium or repeated implantation challenges , PRP may offer a new opportunity for success. Intrauterine hCG Infusion Human chorionic gonadotropin (hCG) is a natural hormone produced by the early embryo. One of its roles is to signal the uterus to prepare for implantation. Administering a small dose of hCG directly into the uterine cavity before embryo transfer may mimic this natural signaling process. Studies suggest intrauterine hCG may: Improve implantation rates Enhance communication between the embryo and endometrium Support early pregnancy development Peripheral Blood Mononuclear Cells (PBMCs) PBMCs are immune cells—such as lymphocytes and monocytes—isolated from a patient’s blood. These cells can be activated in the lab and then infused into the uterine cavity prior to embryo transfer. The goal of PBMC therapy is to modulate the immune response , helping the maternal immune system accept the embryo. PBMC therapy has been explored in women with: Recurrent implantation failure (RIF) Suspected immune-related fertility challenges Emerging studies suggest PBMCs may increase implantation and pregnancy rates by improving the immune environment of the uterus. Who Might Benefit From PRP, hCG, or PBMC Therapies? These investigational intrauterine treatments are typically considered for women who have: Repeated implantation failure despite transferring healthy embryos Thin or unresponsive endometrial lining Suspected immune-related implantation challenges Because these treatments are still experimental , a detailed consultation is essential to determine whether they may be appropriate in your fertility journey. Caperton Fertility Institute’s Commitment At Caperton Fertility Institute in Albuquerque, NM, and El Paso, TX , we are committed to providing innovative, evidence-based fertility treatments. While intrauterine PRP, hCG, and PBMCs remain investigational, they represent promising new tools for patients facing implantation challenges. Our approach is always personalized —we carefully evaluate each patient’s history, test results, and goals before recommending advanced or experimental therapies. Moving Forward With Hope If you’ve experienced repeated implantation failure , we know how discouraging it can feel. At Caperton Fertility Institute , our team offers both cutting-edge science and compassionate care to help you move forward with confidence. 📍 Clinics in Albuquerque, NM & El Paso, TX 📞 Call today or request a consultation online to explore your fertility treatment options and discover whether intrauterine PRP, hCG, or PBMC therapy may be right for you.