Patient acceptance of Self-Operated Endovaginal Telemonitoring (SOET): proof of concept

Initial attempts at obtaining a pregnancy by in vitro fertilization and embryo transfer (IVF-ET) were conducted in a natural cycle (Edwards et al., 1980). It soon became clear that ovarian stimulation using gonadotropins provided a useful tool to obtain more oocytes and increase the chance for success. This resulted in the need to monitor ovarian stimulation, based on serial sonographic assessments of follicular growth and to a lesser degree on serial measurements of serum estradiol (Golan et al., 1994; Lass, 2003). Estradiol measurements became less important and are now considered to be of value mainly in cases of threatening ovarian hyperstimulation syndrome (OHSS). Serial sonography as a sole method of monitoring follicular growth has become routine and cannot be dispensed with, both for optimal timing of HCG administration and for early detection of threatening OHSS. Development of patient-friendly IVF includes self-administration of gonadotropins, milder stimulation protocols (Baart et al., 2007), reduction of multiple pregnancies by single embryo transfer (Gerris et al., 2002) and less ovarian hyper stimulation syndrome, more efficacious embryo freezing programs (Tiitinen et al., 2004) and less treatmentinduced stress. Natural cycles or minimally modified natural cycles have been suggested (Pelinck et al., 2008) to further minimize the impact of IVF treatment on patients’ daily life. In vitro maturation (IVM) also minimizes gonadotropin use (Söderström-Anttila et al., 2006). Still one major inconvenience persists i.e. the need for women to frequently visit the clinic to perform serial vaginal sonographies. Although no hard data Patient acceptance of Self-Operated Endovaginal Telemonitoring (SOET): proof of concept