SONOGRAPHICALLY MONITORED OVARIAN STIMULATION FOR ASSISTED REPRODUCTION - A PROSPECTIVE, BLIND-STUDY

OBJECTIVE: To assess prospectively the appropriateness of follicular s onography alone for monitoring ovarian stimulation and to compare it t o ovarian monitoring with both follicular sonography and hormone level determinations. STUDY DESIGN: Prospective, blind, clinical study in w hich the investigator made cycle management decisions based on follicu lar sonography only. RESULTS: Follicular sonography alone predicted 88 % of the decisions made by the combination of follicular sonography, l uteinizing hormone (LH), estradiol (E(2)) and progesterone measurement s. Follicular sonography was unable to predict abnormal E(2) patterns in eight (8%) of the patients' scans. Follicular sonography did not de tect three (3%) patients with a premature LH surge. CONCLUSION: Follic ular sonograms alone performed during ovarian stimulation predicted 88 % of cycle decisions. One could argue that hormone measurements could be either reduced or eliminated during ovarian stimulation for assiste d reproductive technology and that follicular sonography only would be a cost-effective compromise. The effect of such simplified monitoring on pregnancy rates would require further prospective evaluation.