A new method of Non-Ultrasound Monitoring of Ovarian Stimulation (NUMOS): Mission Possible! - a pilot study

Abstract

Purpose: This study aims to establish the viability of monitoring an appropriate and safe ovarian stimulation without the use of ultrasound and serum hormone testing. Method: As a primary marker for monitoring of the ovarian response, we used urinary estrone-3-glucuronide (E1-3G) growth rate, which was self-measured by patients daily at home, with a portable analyzer, during the stimulation. For an adequate ovarian response, an average daily rate of increase of E1-3G was estimated to be within 25 - 77%. Ovulation trigger day was determined based on the length of the menstrual cycle. The study included 24 women. Inclusion criteria were age < 41 years and AMH >1 ng/mL. A progestin-primed ovarian stimulation protocol (PPOS) with fixed doses of gonadotropins was used. Results: The average female age was 32,9 years (±4.4), BMI 22,7 kg/m2 (±4,3), AMH 3,7 ng/ml (±2,6), stimulation days 10,6 (±1,1), collected oocytes 12,5 (±8,5), MII oocytes 10,6 (±7,8), fertilization rate 83,6% (±22,5), blastocyst 66,4% (±28,6), good quality blastocysts 31,6% (±16,9). Absence of oocyte aspiration was found in one of the cases. There were no cases of OHSS and ovarian stimulation cancellation. Conclusion: This is the first pilot study to successfully apply a new markers for ovarian stimulation monitoring.