Mild stimulation for in vitro fertilization: making progress downward

The prevalence of infertility is ∼9% of married or co-habiting couples in all countries of the world (Boivin et al., 2007). In many cases, the infertility can be treated effectively only by means of assisted reproductive techniques (ART). In some developing countries, however, ART services are too expensive to be offered. Even in developed countries, ART is only available to women who can afford to pay and they often find that the time commitment, discomfort and complications are unbearable. Innovative approaches are needed to dislodge the chief barrier to availability, which is the cost of in vitro fertilization (IVF). In a recent comment to Nature, Alan Trounson said ‘If you remove all the expensive stuff and use low-cost drugs (such as clomiphene) and remove just one or two oocytes, and only transfer one embryo, it can be done for