A minimally monitored assisted reproduction stimulation protocol reduces cost without compromising success.
OBJECTIVE
To determine if a fixed-dose stimulation protocol with monitoring limited to a single ultrasound can provide acceptable outcomes in assisted reproduction technologies (ART) procedures in appropriately selected patients.


METHODS
Prospective study of all minimally monitored ART cycles from 1996 through 1998.


METHODS
University ART program.


METHODS
Eligibility included Institutional Review Board consent, age 18-37, basal FSH < or = 10, normal semen parameters, and regular menses. IVF (n = 81) and GIFT (n = 14).


METHODS
A single ultrasound was performed after 8 or 9 days of stimulation in a fixed-schedule long luteal phase leuprolide protocol. No hormone levels were obtained. Human chorionic gonadotropin was administered when at least 2 follicles were projected to reach 18 mm.


METHODS
Pregnancy, delivery, and implantation rates.


RESULTS
The clinical pregnancy rates were 51% for IVF and 36% for GIFT. Delivery rates were 42% for IVF and 29% for GIFT. The implantation rates for IVF were 23% and 17% for GIFT. No patient was admitted for ovarian hyperstimulation.


CONCLUSIONS
We were able to achieve satisfactory pregnancy and delivery rates in properly selected patients with a minimal monitoring protocol, limited to a single ultrasound near the end of a fixed-stimulation regimen. The reduced time commitment and cost led to a very high patient acceptance of this approach.
Hurst
Bradley S
BS
Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Denver, Colorado, USA. bhurst@carolinas.org
Tucker
Kathleen E
KE
Schlaff
William D
WD
D000328:Adult; D003120:Colorado; D003365:Costs and Cost Analysis; D010064:Embryo Implantation; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D015181:Gamete Intrafallopian Transfer / Q000706:statistics & numerical data; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D008991:Monitoring, Physiologic / Q000191:economics / Q000379:methods; D011247:Pregnancy / Q000706:statistics & numerical data; D011256:Pregnancy Outcome; D027724:Reproductive Techniques, Assisted / Q000191:economics / Q000706:statistics & numerical data*