Trial reportJournal of assisted reproduction and genetics2014
"Mild" vs. "long" protocol for controlled ovarian hyperstimulation in patients with expected poor ovarian responsiveness undergoing in vitro fertilization (IVF): a large prospective randomized trial.
Trial report in Journal of assisted reproduction and genetics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 5 syntheses or guidelines pooled it, 82 citations in OpenAlex.
- Optimal selection of ovarian stimulation protocol for infertile women with diminished ovarian reserve based on Bologna and POSEIDON criteria: a network meta-analysis.Reproductive biology and endocrinology : RB&E · 2026Pooled it
- Controlled ovarian stimulation protocols for assisted reproduction: a network meta-analysis.The Cochrane database of systematic reviews · 2025Pooled it
- Mild versus conventional ovarian stimulation for IVF in poor, normal and hyper-responders: a systematic review and meta-analysis.Human reproduction update · 2021Pooled it
- Oral medications including clomiphene citrate or aromatase inhibitors with gonadotropins for controlled ovarian stimulation in women undergoing in vitro fertilisation.The Cochrane database of systematic reviews · 2017Pooled it
- Gonadotrophin-releasing hormone antagonists for assisted reproductive technology.The Cochrane database of systematic reviews · 2016Pooled it
- Comparison of modified agonist, mild-stimulation and antagonist protocols for in vitro fertilization in patients with diminished ovarian reserve.The Journal of international medical research · 2018Trial
- Comparative prospective study of 2 ovarian stimulation protocols in poor responders: effect on implantation rate and ongoing pregnancy.Reproductive health · 2015Trial
- MildIn vivo (Athens, Greece)Trial
- Article
- Accumulation of embryos to improve outcomes in advanced-age women undergoing IVF/ICSI cycles: a retrospective cohort study.Frontiers in endocrinology · 2026Article
- Modified clomiphene citrate protocol versus gonadotropin-releasing hormone antagonist protocol inFrontiers in endocrinology · 2026Article
- Combination of Continuous Use of Oral Clomiphene Citrate with Injectable Gonadotropins for Ovarian Stimulation: A Single-Center Study.Life (Basel, Switzerland) · 2025Article
- Higher Pregnancy Success Rates in Patients with Diminished Ovarian Reserve < 40 Years When Initially Treated by Intrauterine Insemination with Mild Ovarian Stimulation Compared to In Vitro Fertilization Alone: A Pilot Study.Reproductive sciences (Thousand Oaks, Calif.) · 2025Article
- The cumulative live birth rate and cost-effectiveness of the clomiphene and gonadotropin cotreatment protocol versus the mid-luteal GnRH agonist protocol in women over 35 years old.Scientific reports · 2024Article
- Minimal Stimulation Using Gonadotropin-Releasing Hormone Antagonist is Associated with Higher Live Birth Rates: A National Study of 13,050 Cycles.Women's health reports (New Rochelle, N.Y.) · 2022Article
- VEGF Concentration in a Preovulatory Leading Follicle Relates to Ovarian Reserve and Oocyte Maturation during Ovarian Stimulation with GnRH Antagonist Protocol in In Vitro Fertilization Cycle.Journal of clinical medicine · 2021Article
- Minimal ovarian stimulation is an alternative to conventional protocols for older women according to Poseidon's stratification: a retrospective multicenter cohort study.Journal of assisted reproduction and genetics · 2021Observational
- Association betweenInternational journal of environmental research and public health · 2021Article
- Does the additional use of clomiphene citrate or letrozole for in vitro fertilization deserve more attention?BMC pregnancy and childbirth · 2021Article
- Co-Administration of Clomiphene Citrate and Letrozole in Mild Ovarian Stimulation Versus Conventional Controlled Ovarian Stimulation Among POSEIDON Group 4 Patients.Frontiers in endocrinology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis large prospective, randomized study was designed to compare the "mild" protocol with clomiphene citrate, low-dose gonadotropins and a GnRH-antagonist (CC/Gn/GnRH-ant protocol) with the "long" protocol with a GnRH-agonist and high-dose Gn for the controlled ovarian hyperstimulation (COH) of patients with expected poor ovarian responsiveness undergoing IVF. MATERIALS AND
methodsA total of 695 women with clinical, endocrine and ultrasound characteristics suggesting a low ovarian reserve and a poor responsiveness to COH were recruited and randomly assigned to receive the CC/Gn/GnRH-ant "mild" protocol (mild group, n = 355) or the "long" protocol with high-dose Gn (long group, n = 340).
resultsThe "mild" stimulation led to significantly shorter follicular phase, lower consumption of exogenous Gn and lower peak estradiol level than the "long" regimen. With the "long" protocol, significantly less cycles were cancelled due to the lack of ovarian response; further, it obtained significantly more oocytes, more mature oocytes, more embryos, and a thicker endometrium. As for the final IVF outcome, however, the two stimulation regimens obtained comparable implantation rate, clinical pregnancy rate, and ongoing pregnancy rate at 12 weeks.
conclusionsIn conclusion, the "mild" CC/Gn/GnRH-ant stimulation protocol is a valid alternative to the long protocol with high Gn dose as it obtains a comparable success rate and requires significantly less medications, with an obvious economical advantage.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.