Brief report of time to pregnancy and perinatal outcome in affordable in vitro fertilization (IVF)

The global decline in total fertility rate (TFR) has raised serious concerns about the sustainability of our population. Projections indicate that by 2050, as many as 77% of countries will be below the replacement level of 2.1. Therefore, it is important to recognize family formation as a fundamental human right by ensuring that all women have fair access to fertility care, especially in terms of creating affordable assisted reproductive technologies (ART). Although in vitro fertilization (IVF) has become more common globally, many still face barriers due to financial, logistical, and emotional challenges. Increasing access to affordable ART is crucial, and mild ovarian stimulation has shown promising results for various patient groups. This article delves into clinical outcomes related to cost-effective IVF methods, such as mild ovarian stimulation protocols, the simplified IVF culture system (SCS), natural cycle endometrial preparation, and minimal ovarian stimulation (MOS) for those with poor ovarian response (POR). Recent research supports the use of simple IVF culture systems (SCS) as a method to reduce costs while simultaneously improving perinatal outcomes. Furthermore, factors such as endometrial thickness (EMT) and the approaches to endometrial preparation during frozen embryo transfer (FET) play a significant role in determining the reproductive outcomes. When compared with hormone replacement cycles, endometrial preparation in natural cycles shows better results in reproductive outcome. In Indonesia, minimally stimulated IVF is gaining attention, yet it still encounters challenges regarding costs, accessibility, and clinical expectations. Thus, further enhancements in treatment protocols, human resources, and health infrastructure are essential.