Blood hormone monitoring in controlled ovarian stimulation

Due to changes in monitoring patients that may be attributed to the coronavirus pandemic, we would like to get input on your current practice of blood hormone monitoring during ART treatment. We would appreciate if you could spare a minute or two to answer a few short survey questions on the topic.

It is important to emphasize that the survey covers only current practice, such as what blood hormone monitoring you perform, as well as when and how often – during treatment using controlled ovarian stimulation for ART.

Please specify your medical specialty:
  • Clinician
  • Embryologist
  • Nurse
  • Other

 

How many years have you practiced reproductive medicine? (Please check the answer that applies)
  • Less than 3 years
  • 3 to 5 years
  • 6 -10 years
  • 11 -15 years
  • 16-20 years
  • 21-25 years
  • 26-30 years
  • More than 30 years

 

Is your reproductive medicine center a private or public practice?
  • Public
  • Private
  • Both
  • Other

 

Is ART treatment reimbursed in your country?
  • Fully reimbursed
  • Partially reimbursed
  • Not reimbursed

 

How many oocyte aspiration cycles are performed in your clinic annually?
  • Less than 100
  • 101-500
  • 501-100
  • 1001-1500
  • 1501-2000
  • 2001-3000
  • 3001-4000
  • More than 4000

 

What is the percentage of fresh embryo transfer cycles out of all embryo transfer cycles in your center?
  • 25% or less
  • 26%-50%
  • 51%-75%
  • 76%-99%
  • 100%

 

What is the percentage of freeze-all embryo cycles out of all oocyte aspiration cycles in your center?
  • 25% or less
  • 26%-50%
  • 51%-75%
  • 76%-99%
  • 100%

 

Which tests do you perform during the first clinic visit after the first gonadotropin injection? (Check all that apply)
  • Ultrasound
  • E2
  • P4
  • LH
  • FSH
  • Other

 

Which tests do you perform during the 2nd/3rd clinic visit during controlled ovarian stimulation? (Check all that apply)
  • Ultrasound
  • E2
  • P4
  • LH
  • FSH
  • Other

 

Which tests do you perform on or before the day of ovulation triggering? (Check all that apply)
  • Ultrasound
  • E2
  • P4
  • LH
  • FSH
  • Other

 

How do you adjust the gonadotropin dose during ovarian stimulation? (Please check all statements that apply to you)
  • I don’t change the gonadotropin dose during ovarian stimulation
  • I adjust the dose according to E2 levels
  • I adjust the dose according to LH levels
  • I adjust the dose according to P4 levels
  • I adjust the dose according to ultrasound data

 

Do you use blood E2 levels as indicators of OHSS risk, in general?
  • Yes
  • No

 

How do you decide on a freeze-all cycle for the prevention of OHSS in hyper-responders before ovulation triggering? (Check all that apply)
  • Based on ultrasound data
  • Based on blood hormone levels
  • Other

 

How do you decide on the timing of ovulation triggering? (Check all that apply)
  • Based on ultrasound data
  • Based on blood hormone levels
  • Based on the day of the week
  • Other

 

How do you plan the day of frozen- thawed embryo transfer during natural cycles? (Check all that apply)
  • I do an ultrasound check to confirm ovulation
  • I ask patients to check ovulation using a urine LH test strip
  • I ask patients to do a blood hormone check to predict ovulation and then confirm with an ultrasound
  • In case of hCG/GnRH-agonist triggering, I monitor with a blood hormone test and ultrasound

 

Do you check blood E2 levels during endometrium preparation for artificial/HRT FET cycles?
  • Yes, for all patients
  • Yes, for some patients
  • No

 

Do you check blood LH levels during endometrium preparation for artificial/HRT FET cycles?
  • Yes, for all patients
  • Yes, for some patients
  • No

 

Do you check blood progesterone levels during endometrium preparation for artificial/HRT FET cycles?
  • Yes, for all patients
  • Yes, for some patients
  • No

 

Do you use ultrasounds during endometrium preparation for artificial/HRT FET cycles?
  • Yes, for all patients
  • Yes, for some patients
  • No

 

Do you check blood progesterone levels just before embryo transfer in frozen thawed embryo transfer cycles?
  • Yes, for all/ nearly all patients
  • Yes, for some patients
  • No

 

Do you check blood progesterone levels during the luteal phase to ensure sufficient luteal phase support?
  • Yes, for all / nearly all patients
  • Yes, for some patients
  • No

 

To what extent do you agree with the following statement? (1 means fully disagree and 5 means fully agree).
  • I believe that blood hormone tests play an important role in monitoring ovarian response during ovarian stimulation for ART treatment
  • Blood hormone tests can be useful to guiding decision-making in adjusting the dose of gonadotropins.
  • Blood hormone tests are important to guiding decision-making in preventing OHSS
  • Blood levels of E2 and LH are clinically relevant to deciding when to start GnRH antagonists in flexible protocols