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

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 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.