Ultrasound or ultrasound and hormonal determinations for in vitro fertilization monitoring.

OBJECTIVE To compare pregnancy rate, cost effectiveness, patients effort, related stress, and the ovarian hyperstimulation syndrome (OHSS) rate, between patients monitored for ovarian hyperstimulation using a combination of ultrasound and hormonal determination (combination protocol), in contrast to applying ultrasound only, in in vitro fertilization and embryo transfer (IVF ET). METHOD This study was carried out on a total of 206 patients who underwent ovarian hyperstimulation with human menopausal gonadotropin and human chorionic gonadotropin (hMG/hCG) protocol. The first 110 patients were monitored every other day by ultrasound only protocol (Group I) while the next 96 patients were monitored daily by a combination protocol (Group II). The pregnancy rate, taking home baby rate, OHSS rate and total cost of monitoring for each patient in both groups were calculated and compared. The patients and the IVF team effort and stress were also compared. RESULT Analysis of this study showed no statistical significant differences in clinical pregnancy rate and taking home baby rate between patients in protocol I and II (23.4% vs. 22.9%) and (14.8% vs. 14.3%), respectively. OHSS developed in only two patients--one in each group. The average cost of monitoring was significantly cheaper in Group I--78 Jordanian dinars (JD) vs. 222 JD in Group II (P < 0.0001). (NB: 1 USD = 0.7 JD). CONCLUSION Ultrasound monitoring only proved to be cheaper, more convenient and less time consuming for both the patients and the IVF team. However, no significant difference was found regarding the clinical pregnancy rate and taking home baby rate between the two protocols.