Correlation between sonographic follow-up of follicular growth, serum and salivary estradiol in women undergoing controlled ovarian stimulation (IVF/ICSI).

AIM OF THE STUDY: Investigation of the correlation between serum estradiol (E2), salivary E2 and sonographic measurements of follicles in women undergoing controlled ovarian stimulation (COS) for IVF/ICSI. METHODS: This is a prospective study performed at the Department of Reproductive Medicine of Ghent University Hospital (Belgium) between November 2016 and January 2017 over a total of 40 patients. During routine COS, two-dimensional measurements of the follicles were performed using transvaginal ultrasound (TVUS) and E2 was measured in saliva and serum. A linear Mixed-Effects model (MIXED) was built, using SPSS Statistics 24. RESULTS: Statistical analysis shows a strong linear correlation between serum and salivary E2. For every single unit increase in serum E2 (+ 1 ng/L) the estimated saliva E2 concentration is expected to increase with 0.011 pg/mL (95% CI [0.009 - 0.01]). Strong linear correlations between both saliva and serum E2 and follicular dimensions were also found. For every millimetre increase in follicle diameter the estimated serum E2 concentration is expected to increase with 8.32 ng/L (95% CI [7, 10-9, 54]). For every millimetre increase in follicle diameter the estimated saliva level of E2 is expected to increase with 0.11 pg/mL (95% CI [0.09 - 0.13]). CONCLUSIONS: A strong correlation between serum and salivary E2 concentrations was found. In addition, both are strongly correlated with the product of the number of follicles and their average diameter, measured by TVUS. More investigation needs to be done to find out if salivary E2 is an effective tool for monitoring IVF cycles.

Correlation between follicle dimensions recorded by patients at home (SOET) versus ultrasound performed by professional care providers.

INTRODUCTION: Serial measurements of the number of follicles and their growth by ultrasound is a standard way of monitoring fertility treatments using controlled ovarian stimulation. This is stressful for both the patient and the professional. Self-operated endovaginal telemonitoring (SOET) is more patient friendly and less time-consuming. AIM OF THE STUDY: The goal of the study is to see if there's a correlation in the number of follicles and in two- dimensional growth between recordings made using SOET versus measurements performed by a professional sonographer. RESULTS: Three different ultrasound moments were recorded and compared in a total of 15 women. At time A an ultrasound was performed by the patient at home using SOET at the decision time of triggering. At time B an ultrasound was also recorded by the patient, 24 hours later. At time C an ultrasound was performed by a physician using a high end ultrasound device immediately prior to oocyte retrieval, 12 hours later than time B. The correlation in number and two-dimensional size between the different measurement moments was calculated. There is an excellent correlation in follicle count between time B and C. The difference in mean two-dimensional size between different measurement moments was not statistically significant. CONCLUSION: SOET ultrasound correlates well with ultrasound performed by a professional in number of follicles. SOET is a good alternative for monitoring controlled ovarian stimulation in a well-defined population group of normal responders, especially near the end of the ovarian stimulation.