title: Preprogrammed, unmonitored ovarian stimulation reduces expense without compromising the outcome of assisted reproduction.
abstract: OBJECTIVE
  To determine if a novel, preprogrammed, unmonitored stimulation protocol could reduce the cost of assisted reproductive technology (ART) without compromising outcome or safety.
  
  
  METHODS
  Prospective, nonrandomized study of unmonitored ART versus traditional monitoring.
  
  
  METHODS
  University ART program.
  
  
  METHODS
  Infertile women aged < 39 years, with a basal FSH level < 15 mIU/mL (conversion factor to SI unit, 1.00) and regular menstrual cycles, undergoing ART.
  
  
  METHODS
  Oocyte retrieval was performed at a predetermined time in 72 unmonitored cycles based on age and basal FSH level. No monitoring of any type was performed before retrieval. There were 86 monitored control cycles.
  
  
  METHODS
  The number of oocytes, and embryos; complications including ovarian hyperstimulation.
  
  
  RESULTS
  The total cost for unmonitored ART was significantly less than for monitored cycles. There was no difference between groups for patient age, number of oocytes obtained, or number of metaphase II oocytes. For non-male-factor patients, the number of oocytes fertilized, number of embryos transferred, and the clinical pregnancy rates were comparable. There was one case of severe hyperstimulation requiring hospitalization in the unmonitored group.
  
  
  CONCLUSIONS
  This novel, unmonitored ovarian stimulation protocol provides ART at a significantly lower cost than is incurred with traditional monitoring, with no apparent compromise in outcome.
authors.affiliation: Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Denver 80262, USA. HURST@BINAR.UHCOLORADO.EDU
authors.forename: B S
authors.initials: BS
authors.lastname: Hurst
authors.forename: K E
authors.initials: KE
authors.lastname: Tucker
authors.forename: C A
authors.initials: CA
authors.lastname: Awoniyi
authors.forename: W D
authors.initials: WD
authors.lastname: Schlaff
mesh_terms: D000293:Adolescent; D000328:Adult; D002452:Cell Count; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000627:therapeutic use; D017048:Health Care Costs; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D008596:Menotropins / Q000627:therapeutic use; D008991:Monitoring, Physiologic / Q000191:economics*; D009865:Oocytes; D011247:Pregnancy; D011446:Prospective Studies; D012099:Reproductive Techniques / Q000191:economics*
chemical_list: D006063:Chorionic Gonadotropin; D008596:Menotropins; D005640:Follicle Stimulating Hormone; D016729:Leuprolide