Ovulation monitoring at home during IVF as successful as hospital testing

Use of urine hormone test strips by women to monitor ovulation, prior to IVF embryo transfer, results in the same pregnancy rate at 12 weeks, as those who had hospital-based ovulation monitoring.

Ovulation monitoring prior to frozen embryo transfer is carried out in hospital over three or four visits, using ultrasound to monitor the thickness of the endometrium and size of the follicle. The aim is to transfer a thawed embryo into the uterus at the correct stage in the menstrual cycle to ensure optimum conditions for implantation and development. The success of both the implantation and, thus, an overall pregnancy relies heavily on embryo transfer occurring during ovulation when the uterus lining is fully built up. Now a study published in The Lancet has suggested this could be monitored equally well at home using urine hormone test sticks.

Project leader Dr Femke Mol a gynaecologist and specialist in reproductive medicine at the Amsterdam University Medical Centres in the Netherlands said: 'Women experience home monitoring as more private and they feel more empowered during this treatment. In addition, there are significant benefits when it comes to durability and cost when women can do most of this treatment from home. There are far fewer travel movements, so it's also better for the environment.'

The study involved 1464 women who had regular ovulatory menstrual cycles, split evenly and randomly between two groups of 732 individuals. The first group underwent testing in hospital to detect the start of the ovulation stage of their menstrual cycle, while the other group monitored their ovulation using urine testing kits at home. Specifically, the test kits measured for luteinising hormone in the women's urine, the presence of which signifies the beginning of ovulation, when an egg is released.

Women who had their ovulation monitored in hospital were given hormone injections to help induce ovulation, which the women testing for ovulation at home did not receive.

Researchers found that 20.8 percent of women who detected ovulation at home were pregnant at 12 weeks gestation following embryo transfer, compared to 20.9 percent of women who had their ovulation detected in hospital. Thus, similar success rates were observed between the two ovulation monitoring schemes. Hospital-based monitoring of ovulation resulted in a higher pregnancy rate in women under 25, but the difference between the two groups was less significant in older women.

Live birth rates were 20.4 percent for women in the home-based ovulation detection group, compared to 20.8 percent who had their ovulation detected in hospital.  

The findings suggest clinics and patients could see similar pregnancy rates following home-based ovulation detection during IVF, with less financial burden due to fewer hospital visits, and the lower cost associated with avoiding hormone treatment to induce ovulation, in women with regular ovulation.