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has been cited by the following article:

• TITLE: A New Protocol for Controlled Ovarian Stimulation Monitoring by Self-Determination of Estrone-3-Glucuronide and Single Ultrasound (COSSESU)

  AUTHORS: Iavor K. Vladimirov, Martin Vladimirov, Desislava Tacheva

  KEYWORDS: COS Monitoring, E3G, Estradiol, TVUS, Telemedicine

  JOURNAL NAME: Open Journal of Obstetrics and Gynecology, Vol.11 No.9, September 26, 2021

  ABSTRACT: Background: Answering the question of what is the optimal protocol for monitoring controlled ovarian stimulation (COS) still remains a challenge. The rapid introduction of new diagnostic methods and various components of telemedicine makes it possible to reduce the number of patient visits during ovarian stimulation, which will reduce the loss of time, costs, and risk for the patient from COVID-like situations. Methods: The different COS monitoring protocols are examined, thus proposing a new approach consisting of two successive phases. Results: In the first phase, E3G in urine samples is being examined, which is performed by the patient themselves with a small portable analyzer. Based on the results, the specialist prescribes the doses for stimulation. The second phase involves one single determination of the size and number of follicles at the end of stimulation, using TVUS, as well as the dynamics of serum levels of P4 and E2. This proves to be in many cases sufficient. Conclusions: It is of our opinion that on the basis of new diagnostic tests such as E3G in urine and telemedicine, patients are able to independently and actively participate in the treatment process. This new approach to COS monitoring can be successfully implemented in different protocols for ovarian stimulation.