Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biol
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A Non-Randomized Clinical Trial of a Decision Support Tool to Optimize Superovulation Cycles in Individual Patients

Urmila Diwekar, Nayana Patel, Niket Patel, Molina Patel, Harsha Bhadarka, Paresh Ghoghari, Harmi Thakkar, Richa Ainani, Sanjay Joag

Objective: We assessed the effectiveness of a clinical decision support tool to reduce follicle-stimulating hormone dosage and eliminate the need for an ultrasound after day 5 of an individual superovulation cycle.

Design: Test participants undergoing superovulation were compared with retrospective control subjects.

Subjects: 22 test and 22 control participants included normal and poor responders and patients with the polycystic ovarian syndrome.

Intervention: A clinical decision support tool was used to predict stimulatory hormone dosage for an individual cycle based on follicle size distribution on day 1 and day 5.

Main outcome measures: Cumulative stimulatory hormone doses, number of oocytes, numbers of MII oocytes, and high-quality embryos obtained during the cycle.

Results: Test participants required significantly lower cumulative FSH doses during superovulation cycles (average 1856 IU test, 2760 IU control, p<0.001), with significantly higher numbers of high-quality embryos (average 5.7 test, 2.1 control, p=0.0003). Test participants had higher numbers of MII follicles, although the difference was not statistically significant (average 9.7 test, 7.9 control, p=0.271).

Conclusion: The use of the clinical decision support tool eliminated the need for ultrasound exams after day 5, reduced the doses of stimulatory hormone required, and yielded significantly higher numbers of high-quality embryos.