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Chapter 4 - ART Monitoring: An End to Frequent Clinic Visits and Needle Sticks?

Published online by Cambridge University Press:  02 March 2020

Alice D. Domar
Affiliation:
Boston IVF, Waltham, MA
Denny Sakkas
Affiliation:
Boston IVF, Waltham, MA
Thomas L. Toth
Affiliation:
Boston IVF, Waltham, MA
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Summary

Since the early eighties there has been tremendous evolution in the clinical approach to ART and in how to practically carry execution of these treatments. From a patients’ perspective, some of the most significant innovations were: complete replacement of laparoscopic oocyte retrieval under general anesthesia by transvaginal puncture guided by sonography; total disappearance of E2 monitoring using urinary assessments in favor of serum determinations; clinical use of both agonists and antagonists to suppress endogenous LH-peaks avoiding LH-peak monitoring through three-hourly urine collections; specifically designed calibrated devices, called pens, to allow patients to inject daily gonadotrophins themselves instead of being dependent on nurses or hospital facilities willing to inject hCG at odd hours; and recognition of psychological stress leading to active intervention of mental-health professionals in helping patients to cope with both the infertility and with its treatments.

Type
Chapter
Information
Patient-Centered Assisted Reproduction
How to Integrate Exceptional Care with Cutting-Edge Technology
, pp. 39 - 53
Publisher: Cambridge University Press
Print publication year: 2020

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