For me, one of the most challenging aspects of undergoing in vitro fertilization (IVF) was making all those monitoring appointments—OK, other than the mood swings from the hormones, painful daily injections, fear over the process not working, and an overwhelming feeling of loneliness, since I didn’t share what I was going through with most people in my life.

Beyond all of that, the clinic where I was seeking reproductive assistance happened to be 45 minutes from our house, which meant waking up at 5 a.m. to get to my bloodwork and ultrasound appointments before work. If I could have partaken in-home monitoring via pain-free urine analysis, and that was just as effective, I would have been game. Now, a new study claims this is possible.

The study, which was conducted by Amsterdam UMC, and published in The Lancet, looked at the timing of frozen embryo transfers (FET) during the IVF cycles of 1,464 women at 23 hospitals and clinics throughout the Netherlands.1

As anyone who has undergone FET knows, getting that timing piece right for the best chances of success is key, which is why we go to all those monitoring appointments. The researchers looked at 732 women in the study who had undergone home monitoring of ovulation, and 732 who had their cycle monitored in a hospital setting. They found the outcomes were the same. Pregnancy occurred in 152 participants who did home monitoring (20%), while the hospital-based monitoring group experienced ongoing pregnancy in 153 cases, also about 20%.

“Home-based monitoring of ovulation is non-inferior to hospital-controlled monitoring of ovulation to time FET,” the researchers reported in the study.

As someone who may consider IVF again in the future, I wanted to find out how hopeful to be in light of this study, so I turned to Banafsheh Kashani, MD, an OB-GYN, reproductive endocrinologist, and infertility specialist in Laguna Hills, California. “The study is good because it is a multi-center study, which means that there are some variations in the providers providing care and the patients,” Dr. Kashani explains.

She adds the number of patients who participated also lends credibility to it. However, she did make one note. “The only issue was that this was a non-inferiority study,” Dr. Kashani says. “This means that it is not saying this method is better. It’s just not worse or inferior to the standard of hospital or doctor monitoring of ovulation.”
Mark Leondires, MD, a Connecticut-based fertility doctor at Illume Fertility also points out a weakness in the findings, sharing that at-home monitoring comes with its own unique challenges and stresses. He says sometimes patients may feel uncertain about trying to read the urine predictor kit strips themselves.

“Knowing that every single embryo transfer is a precious event, patients who live in closer proximity to their doctor’s office or clinic often choose to go in for monitoring, and knowing that they are getting the best, most accurate information provides a sense of relief and confidence,” says Dr. Leondires. “Monitoring performed by a medical professional consists of both bloodwork and ultrasound, which provides more reliable results, as well as an opportunity to assess the thickness of the uterine lining prior to transfer,”

Dr. Kashani agrees. “Some women have irregular menstrual cycles and it is too difficult to monitor at home,” she adds. Women with polycystic ovary syndrome (PCOS) have high baseline LH hormone levels, and may also benefit from hospital monitoring.

Still, at-home monitoring in combination with hospital monitoring can be helpful. “I personally like to have patients do both in-person monitoring and home monitoring. The combination of this data together is best to personalize treatment plans and optimize success for patients,” Dr. Kashani says.

I personally like to have patients do both in-person monitoring and home monitoring. The combination of this data together is best to personalize treatment plans and optimize success for patients.

— BANAFSHEH KASHANI, MD
Meanwhile, as Leondires notes, if patients do indeed live far away from a clinic, at-home monitoring can be considered in some cases to ease the travel burden. It’s important to note the study authors also looked at how at-home fertility monitoring can make a positive environmental impact in the future by reducing travel.

Speaking of looking ahead, Dr. Leondires tells Parents, that home monitoring could be the way of the future. “There is certainly a shift within the field, and also within the United States, to move towards the option of home monitoring,” he explains. “This can increase convenience for patients and provide equivalent outcomes in some cases, as is supported by this study.”

The immediate takeaway for IVF patients, and people considering undergoing reproductive assistance, is you should always ask your provider about their latest protocols, including what kind of monitoring they may offer.

“As with any new research, it is important to understand that this decision should be personalized on an individual basis for each patient,” says Dr. Leondires.

Dr. Kashani seconds this message of individualized care and self-empowerment. “Be open with your provider. Sometimes, women have an intuition about their bodies as well, and it’s OK to share with your doctor what you are feeling.”