Outcome of one hundred consecutive ICSI attempts using patient operated home sonography for monitoring follicular growth

OBJECTIVE: cohort study describing clinical and laboratory outcomes in ICSI patients using self-operated endovaginal tele-monitoring (SOET). SETTING: University department of reproductive medicine. PATIENTS: 78 patients undergoing 100 consecutive ICSI attempts. INTERVENTIONS: patients’ recorded vaginal sonograms and sent recordings using the cloud based Sonaura device to the care provider who procured responses, avoiding hospital visits. MAIN OUTCOME MEASURES: Number of cycles without hospital visit, laboratory and clinical variables, transportation avoided. RESULTS: In 100 attempts, only one patient missed her follicles, 9 hospital visits occurred for circumstantial reasons and 90 attempts were completed without any hospital visit between initiation and puncture. Mean number ± 2SD was for oocytes 11.7±6.6, metaphase-II oocytes 8.5±5.4, 2PN zygotes 5.5±3.7, good day-5 blastocysts 2.4±2.4, embryos transferred 1.0±0.7 and embryos frozen 1.3±2.2. Percentages of total (+HCG), clinical (cardiac activity) and on-going pregnancies (>20 weeks) were 40%, 35% and 29% per started cycle and 48.8%, 42.7% and 35.4% per embryo transfer. CONCLUSIONS: Using SOET, 90% of ICSI (and IVF) patients can avoid visits to care providers for making sonograms. Results were similar as in patients with a similar profile using traditional monitoring. In appropriate patients, SOET is an efficient, safe and patient-friendly alternative for ovarian stimulation monitoring in IVF/ICSI programmes.