Self-operated endovaginal telemonitoring (SOET): a step towards more patient-centred ART?

The need for serial vaginal sonographies to monitor ovarian stimulation for artificial reproductive technology (ART) treatments remains a major practical and organizational drawback both for patients and health-care providers. We explore the possibility of patients and/or their partners performing their own vaginal sonographies at home. To make this a reality, a portable, easy-to-use, home-applied vaginal probe for recording relevant images would have to be developed, as well as appropriate software to transfer images using modern communication technology to the centre, to analyse the recordings and to send a swift structured response, comprising dosing advice and next-step instructions. A simplification of the uncontested need to perform these sonographies, even if applicable to just a selected proportion of IVF patients, could fit in the general tendency to make IVF more patient centred and friendly, to implement telemedicine and to increase patient empowerment by supervised active participation to their treatment. The advantages of such a technology are explored in this paper, aiming at opening up a debate on whether patients themselves would, could and should achieve a further substantial simplification of ART without loss of quality while strongly curbing costs.