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Home- or hospital-based monitoring to time frozen embryo transfer in the natural cycle? Patient-reported outcomes and experiences from the antarctica-2 randomised controlled trial

Human Reproduction Apr 28, 2020

Zaat TR, de Bruin JP, Goddijn M, et al. - Modern IVF involves frozen–thawed embryo transfer (FET) as an essential component and following FET cycles are mainly used: artificial cycle FET, using artificial preparation of the endometrium with exogenous progesterone and oestrogen, and natural cycle FET (NC-FET). During a natural cycle FET, repeated hospital visits are made by women and an ovulation trigger was done to time FET (ie modified NC-FET or hospital-based monitoring). Per previous Antarctica randomized controlled trial (NTR 1586), modified NC-FET vs artificial cycle FET is more cost-effective. Alongside the Antarctica-2 RCT comparing the cost-effectiveness of home-based monitoring of ovulation with that of hospital-based monitoring of ovulation, researchers here investigated the patient-reported outcomes (PROs) and patient-reported experiences (PREs) in home-based monitoring compared with those in hospital-based monitoring of ovulation for scheduling FET. PROs and PREs were assessed at three time points: (i) before randomization, (ii) at the time of the FET and (iii) at the time of the pregnancy test. Among 260 randomized women, before randomization data were available for 232 women (home-based monitoring n = 116, hospital-based monitoring n = 116).  Analysis revealed that anxiety/sadness symptoms increase over time among women undergoing either home-based or hospital-based monitoring, but women undergoing home-based monitoring identified themselves as more empowered during the treatment and classified the monitoring as more discreet compared with hospital-based monitoring.

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