Experience with ultrasound.

Treatment with human menopausal gonadotropins is safe and effective. However, in order to maintain those properties, careful monitoring of the ovarian response to the exogenous gonadotropins is mandatory. Safety is afforded by the use of rapid assays of the estrogen level in serum or urine. The use of real-time ultrasonography to monitor follicular growth has improved the efficacy. The administration of human chorionic gonadotropin (hCG) can be delayed until follicular maturation has been achieved; hCG can be withheld if too many mature follicles are present. Monitoring therapy with both modalities as well as with clinical methods ensure a high rate of successful gestations.