Do you have any knowledge of a procedure my doctor calls "short cycle IVF"? We tried it last month. I took 100mg of Clomid on cycle days 2-6. He monitored my LH surge, and did ultrasound on day 11 and found three follicles (14mm, 16mm, 17mm). On day 12 I tested positive for LH surge and the cycle was cancelled. One follicle had shrunk to 10mm, one grew to 26mm on day 12 per an ultrasound before the surge detection. The doctor thinks I should try again, but I can't find any information on this procedure. How does it differ from regular approaches, and why should it be any better? My infertility is due to a tubal eight years ago -- everything else seems to function okay.

--Sarah

While "short-cycle" or "mini-cycle" IVF was the rage a few years ago, it just does not seem appropriate now. The rationale for the procedure is that the cost is lower because you do not use expensive gonadotropin injections. Unfortunately, the number of women who retrieve no good eggs and fail to have any embryos to transfer is so high that this procedure does not make sense. There is not much difference in the cost and risk of performing a retrieval for one to two eggs and 20 eggs. Now that IVF clinical pregnancy rates can reach 40 percent or higher per retrieval in well-screened individuals, I think that using standard medical stimulations for IVF is the most cost-effective approach.

You did not say how old you were or how your tubes were tied. But for most women in that position, microsurgical reanastomosis (a procedure that uses microscopic sutures to hook the tubes back together) provides the highest pregnancy rate at about the same cost as IVF.