***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract In a non-r and omized , comparative prospect i ve study ( 416 patients ) we compared the outcome of  IVF/ICSI  in two parallel control groups : one in which patients were followed up using combined monitoring ( ultrasound plus serum estradiol monitoring , the UHM group ) and one in which only ultrasound monitoring was used ( the UM group ) . This study has taken the number of mature oocytes at the moment of egg retrieval as its primary end variable . After adjustment for age , gravidity , antagonist protocol , AMH and infertility diagnosis , the average difference in number of mature oocytes between the UHM group and the UM group was −0.4 ( 95 % CI : −1.7 to 1.0 ) , which met our definition of clinical equivalence ( 95 % CI for the adjusted mean difference between −2 and 2 ) . Larger studies are still needed to evaluate the differences in the live birth rates per cycle and to further confirm that blood sampling definitively has no added value in monitoring ovarian stimulation for IVF/ICSI . Chinese abstract 我们在一项非随机、对照、前瞻性研究中（416例患者）比较了IVF/ICSI中两个平行对照组的结果：一组患者应用超声联合血雌二醇进行监测（ultrasound plus serum estradiol monitoring，UHM），一组患者仅应用超声监测（ultrasound monitoring，UM）。本研究以取卵时成熟卵母细胞的数量为主要研究终点。在对年龄、孕次、拮抗剂方案、AMH水平、不孕症诊断进行校正后，UHM组和UM组的成熟卵母细胞数量的平均差异是-0.4（(95 % CI ： -1.7- 1.0），这与临床等效的定义相符（调整后的平均差的95 % CI介于-2到2之间）。仍需要更大型的研究来评估周期活产率及进一步确定IVF/ICSI中采血检测对卵巢刺激监测的最终结果无附加价值 St and ard monitoring of controlled ovarian hyperstimulation ( COH ) includes  hormone assays ( estradiol , LH , progesterone )  and regular pelvic ultrasound examination .  We report a r and omized study on an attempt to simplify monitoring of COH . Ultrasound monitoring of the cycle alone did not affect pregnancy rates and did not increase the risks of OHSS . These results encourage the future simplification of stimulation protocol Objective : To evaluate if monitoring patients by ultrasound ( US ) only during in vitro fertilization ( IVF ) treatment is safe . Design : R and omized prospect i ve study . Intervention : Patients undergoing their first IVF treatment were r and omized into two groups . The ultrasound only group ( study group ) was monitored by US for follicle size and endometrial thickness without blood tests .  In this group , only one blood test was taken before human chorionic gonadotropin ( hCG ) injection , to ensure a safe level of estradiol ( E2 ) regarding ovarian hyperstimulation syndrome ( OHSS ) risk . The control group was monitored by ultrasound plus serum estradiol and progesterone concentration at each visit . Main outcome measure : Clinical pregnancy rate . Results : No differences were found between the groups in the parameters of IVF treatment , induction days , number of ampoules , E2 level of hCG , as well as embryo quality . The clinical pregnancy rate was not statistically different between the groups , 57.5 % vs. 40.0 % , respectively ( p = 0.25 ) . No OHSS cases were found among the study or control groups . Conclusion : Ultrasound as a single monitoring tool for IVF cycles is reliable , safe , patient friendly , and reduces treatment expenses . In an era of cost effectiveness awareness , this regimen should be considered for routine management in IVF programs OBJECTIVE To determine if there is an optimum time for the administration of human chorionic gonadotropin ( hCG ) after pituitary desensitization with gonadotropin-releasing hormone agonists ( GnRH-a ) has been achieved before ovarian stimulation for in vitro fertilization ( IVF ) . DESIGN Prospect i ve r and omized study . PATIENTS Two hundred forty-seven patients undergoing an IVF treatment cycle who were r and omly divided into three groups . INTERVENTIONS All patients were administered subcutaneously buserelin acetate 500 micrograms/d from day 1 of the menstrual cycle . After pituitary desensitization had been achieved at least 14 days later , ovarian stimulation with human menopausal gonadotropin was commenced . Ovarian stimulation , cycle monitoring , oocyte recovery , and IVF and embryo transfer ( ET ) techniques were identical in all three groups . Patients in group 1 ( n = 79 ) had hCG administered when the mean diameter of the largest follicle had reached 18 mm , at least two other follicles were greater than 14 mm , and serum estradiol ( E2 ) levels were consistent with the number of follicles observed on ultrasound . Patients in groups 2 ( n = 84 ) and 3 ( n = 84 ) had hCG administered 1 day and 2 days , respectively , after the above criteria had been reached . RESULTS The mean day of hCG administration ( P less than 0.01 ) , maximum serum E2 concentration ( P = 0.06 ) , number of days of serum E2 rise ( P = 0.03 ) , and mean diameter of the largest follicle ( P less than 0.0001 ) were significantly different . There were , however , no significant differences in the mean number of preovulatory and medium size follicles , number of oocytes recovered or embryos transferred . There were also no significant differences in the oocyte recovery , fertilization and cleavage rates , in the number of embryos frozen , or in the pregnancy rates per initiated cycle and per ET . CONCLUSIONS There is no significant advantage in the precise timing of hCG administration after pituitary desensitization with GnRH-a OBJECTIVE To determine whether cycle monitoring using both serum E(2 ) and ultrasound findings yields superior clinical pregnancy rates during IVF-embryo transfer ( ET ) compared to monitoring with ultrasound alone . DESIGN Prospect i ve , r and omized , multicenter , patient-blinded study . SETTING Four assisted conception units in the United Kingdom . PATIENT(S ) Two hundred ninety-seven women believed to be normal responders undergoing IVF treatment . INTERVENTION(S ) Patients were r and omly allocated on day 7 of stimulation to one of the two hCG administration criteria : [ 1 ] the E(2)-to-follicle > or = 11 mm ratio was between 250 and 500 pmol/L/follicle and at least 2 follicles reached a mean diameter of 18 mm or [ 2 ] at least 2 follicles reached a mean diameter of 18 mm and the endometrium thickness was > or = 8 mm . MAIN OUTCOME MEASURE(S ) Duration and cumulative dose of recombinant human FSH , total number of growing follicles , oocytes retrieved , number and quality of embryos , pregnancy rates , and ovarian hyperstimulation syndrome ( OHSS ) rates . RESULT ( S ) Two hundred ninety-seven patients were r and omized to one of the two criteria groups . Of these , 288 ( 97 % ) received urinary (u)-hCG ( 143 in group A and 145 in group B ) . One hundred three women in group A ( 72 % ) met both criteria for hCG administration . Pregnancy and OHSS rates were similar ( 34.3 % vs. 31.4 % and 4.9 % vs. 4.1 % , respectively ) . CONCLUSION ( S ) The addition of E(2)/follicle criteria to ultrasound monitoring of IVF cycles in normal responders seldom changes the timing of hCG , and does not increase pregnancy rates or the risk of OHSS OBJECTIVE To evaluate the effect of a new automated technique of follicle measurement ( Sono automated volume calculation [ SonoAVC ] ) on the timing of oocyte maturation and subsequent oocyte retrieval . DESIGN Prospect i ve r and omized controlled trial . SETTING University-based Assisted Conception Unit . PATIENT(S ) Seventy-two women undergoing their first cycle of assisted reproduction treatment . INTERVENTION(S ) The timing of final follicle maturation and oocyte retrieval based on follicle tracking with use of either conventional two-dimensional ( 2D ) ultrasound or SonoAVC . MAIN OUTCOME MEASURE(S ) The number of mature oocytes retrieved and clinical pregnancy rate . RESULT ( S ) The number of the mature oocytes collected ( 10.70 + /- 6.08 vs. 11.43 + /- 6.17 ) , the number of fertilized oocytes ( 7.27 + /- 4.78 vs. 7.97 + /- 5.25 ) , and the clinical pregnancy rates ( 42 % vs. 43 % ) were similar with both 2D ultrasound and SonoAVC methods . CONCLUSION ( S ) Automated follicle tracking using SonoAVC identifies a comparable number of follicles to real-time 2D ultrasound in this preliminary study . Timing final follicle maturation and egg retrieval on the basis of these automated measures does not appear to improve the clinical outcome of assisted reproduction treatment OBJECTIVE To investigate the feasibility of  IVF treatment  with minimal monitoring during ovarian hyperstimulation . DESIGN Retrospective analysis and prospect i ve study with real-time control group . SETTING Transport IVF program with transport clinic and satellite clinics . PATIENTS One hundred consecutive IVF cycles monitored at a transport clinic and 100 concurrent consecutive cycles monitored at satellite clinics , using the same stimulation-monitoring protocol and result ing in oocyte aspiration , are compared retrospectively for the number of ultrasound ( US ) measurements carried out during monitoring and for results of IVF treatment . No patient selection took place . After introduction of a minimal monitoring protocol at a transport clinic , a prospect i ve study was started comparing 100 minimal monitoring cycles at a transport clinic  with 100 concurrent conventional monitoring cycles at satellite clinics  , all result ing in oocyte aspiration . Patients entered the retrospective or prospect i ve study only once . In all cases the same laboratory facility was used . Monitoring of ovarian hyperstimulation was done with US measurements only . Cycles were canceled for impending ovarian hyperstimulation syndrome ( OHSS ) when > 35 follicles were seen to develop during hyperstimulation . RESULTS Retrospective analysis shows no difference for the average number of US measurements at transport and satellite clinics ( 2.8 + /- 0.9 and 3.0 + /- 1.0 ; mean + /- SD ) . No differences were found in the number of ongoing pregnancies obtained in the two groups : 22 and 18 , respectively . One case of severe OHSS occurred in the satellite clinic group . Introduction of minimal monitoring at the transport clinic gives a significant reduction of the average number of US measurements at the transport clinic compared with satellite clinics , where conventional monitoring continued to be used ( 1.5 + /- 0.8 versus 2.8 + /- 0.9 ) . Ongoing pregnancies at transport and satellite clinics numbered 33 and 26 , respectively . In both groups one patient developed severe OHSS . Sixty-two percent of cycles at the transport clinic were monitored with one US measurement only . No cancellations for impending OHSS occurred during the study period . CONCLUSION A large group of patients need only one US measurement during monitoring of ovarian hyperstimulation . Minimal monitoring gives a useful further simplification of the clinical phase of IVF treatment , without adverse effects on treatment outcome and incidence of OHSS OBJECTIVE To assess prospect ively the appropriateness of follicular sonography alone for monitoring ovarian stimulation and to compare it to ovarian monitoring with both follicular sonography and hormone level determinations . STUDY DESIGN Prospect i ve , blind , clinical study in which the investigator made cycle management decisions based on follicular sonography only . RESULTS Follicular sonography alone predicted 88 % of the decisions made by the combination of  follicular sonography , luteinizing hormone ( LH ) , estradiol ( E2 ) and progesterone measurements .  Follicular sonography was unable to predict abnormal E2 patterns in eight ( 8 % ) of the patients ' scans . Follicular sonography did not detect three ( 3 % ) patients with a premature LH surge . CONCLUSION Follicular sonograms alone performed during ovarian stimulation predicted 88 % of cycle decisions . One could argue that hormone measurements could be either reduced or eliminated during ovarian stimulation for assisted reproductive technology and that follicular sonography only would be a cost-effective compromise . The effect of such simplified monitoring on pregnancy rates would require further prospect i ve evaluation A total of 114 patients admitted to an in-vitro fertilization-embryo transfer programme for the first time , were r and omly assigned to the study group or controls . Gonadotrophin-releasing hormone analogue ( GnR 
    Output:
    
This review up date found no evidence from r and omised trials to suggest that combined monitoring by TVUS and serum estradiol is more efficacious than monitoring by TVUS alone with regard to clinical pregnancy rates and the incidence of OHSS .
The number of oocytes retrieved appeared similar for both monitoring protocol s. The data suggest that both these monitoring methods are safe and reliable .