Home self-sonograms for assisted reproduction comparable to in-office imaging

1. Patients performing self-operated endovaginal telemonitoring (SOET) had comparable pregnancy rates to patients in the non-SOET group. 

2. Patients in the SOET group had higher satisfaction and sense of empowerment during their assisted reproductive technology (ART) experience. 

Evidence Rating Level: 2 (Good) 

Study Rundown: As the number of women who use assisted reproductive technology (ART) continues to grow, attempts are being made to make the process more patient-friendly. Currently, women undergoing intracytoplasmic sperm injection are regularly monitored during the ovarian stimulation phase. This monitoring includes frequent office visits for serial vaginal sonograms to measure the number and size of follicles, which is necessary to titrate gonadotrophin doses and to time hCG injection accordingly. This can often be an inconvenience to women using ART, resulting in increased healthcare costs, lost productivity at work resulting in increased cost to both patients and society. Prior work has shown that it is both feasible and acceptable to teach patients to perform sonograms at home and electronically transmit images to their providers for interpretation. The present work is the first study to compare self-operated endovaginal telemonitoring (SOET) to current standard of care. Findings suggest that for patients who feel capable, self-sonography is a strategy that may result in improved patient satisfaction and empowerment, as well as decreased costs, while achieving clinical outcomes comparable to sonography peformed by healthcare providers.

Limitations of the present work include small sample size and limited generalizability. Of note, many of the patients deemed eligible for the study who declined participation reported that their reason was lack of confidence that they could produce adequate videos. This suggests that patients included in this study may have been more confident and empowered at baseline such that findings may not be applicable to all women undergoing ART. Future investigations might include a larger RCT in diverse demographics to confirm the findings highlighted herein and assess potential for broad application.

Click to read the study in Human Reproduction

Relevant Reading: Self-operated endovaginal telemonitoring (SOET): a step towards more patient-centred ART?

In-Depth [randomized controlled trial]: This study evaluated the effectiveness of SOET during ovarian stimulation (n=59) as compared to traditional in-office monitoring (n=62). Outcomes of interest include number of metaphase II oocytes, acceptability to patients and cost.

Women randomized to the SOET group had a comparable number of metaphase II oocytes (p=0.27). The rate of positive hCG tests and ongoing pregnancies were also not significantly different (p=0.47, p=1.00 respectively). Women in the SOET reported higher personal and partner satisfaction, empowerment, active partner participation and discretion (p<0.001).

More from this author: Induction of labor more successful with standardization, The TRINOVA-1 trial: trebananib decreases progression of recurrent ovarian cancer, Contraceptive use before first intercourse linked with improved reproductive outcomes, HPV catch-up vaccine completion low among pregnant and black women, Low screening rates for smokeless tobacco use in pregnant women 

Image: PD 

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