Preprogrammed, unmonitored ovarian stimulation reduces expense without compromising the outcome of assisted reproduction

Objective: To determine if a novel, preprogrammed, unmonitored stimulation protocol could reduce the cost of assisted reproductive technology (ART) without compromising outcome or safety. Design: Prospective, nonrandomized study of unmonitored ART versus traditional monitoring. Setting: University ART program. Patient(s): Infertile women aged <39 years, with a basal FSH level <15 mIU/mL (conversion factor to SI unit, 1.00) and regular menstrual cycles, undergoing ART. Intervention(s): Oocyte retrieval was performed at a predetermined time in 72 unmonitored cycles based on age and basal FSH level. No monitoring of any type was performed before retrieval. There were 86 monitored control cycles. Main Outcome Measure(s): The number of oocytes, and embryos; complications including ovarian hyperstimulation. Result(s): The total cost for unmonitored ART was significantly less than for monitored cycles. There was no difference between groups for patient age, number of oocytes obtained, or number of metaphase II oocytes. For non-male-factor patients, the number of oocytes fertilized, number of embryos transferred, and the clinical pregnancy rates were comparable. There was one case of severe hyperstimulation requiring hospitalization in the unmonitored group. Conclusion(s): This novel, unmonitored ovarian stimulation protocol provides ART at a significantly lower cost than is incurred with traditional monitoring, with no apparent compromise in outcome. (C) 1997 by American Society for Reproductive Medicine.