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 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 below 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. Conclusions: This is the first pilot study to successfully apply a new marker for ovarian stimulation monitoring.
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