This is a prospective, observational, single center study which will be conducted at the
Rabin Medical Center (Beilinson Campus), Petach Tikva, Israel, a tertiary university
hospital. Fifty healthy woman (≤45 years old) undergoing IVF treatment will be enrolled
following filling out an informed consent form.
Study procedure:
Women will be recruited in the IVF department upon consulting with the fertility specialist.
Following signed informed consent, patients' blood pressure will be measured using a
non-invasive upper arm blood pressure. Cardiovascular monitoring will be carried out using
non-invasive NICAS cardiac impedance cardiography by the use of two electrodes stickers which
are pasted on the wrists for 6 minutes.
Monitoring will be performed on:
1-3rd day of the menstrual cycle prior to treatment with gonadotropins
On the day of ovulation triggering
On the day of ovum pickup prior to their entrance to the operating theater.
On the day of embryo transfer.
IVF Protocol:
The antagonist protocol consists of daily gonadotropin stimulation from day 3 or 4 of
menstruation. In addition, once the leading follicle reached 13-14 mm, daily injections of
Cetrotide 0.25 mg (Serono, Switzerland) or Orgalutran 0.25 mg (N.V. Organon, the Netherlands)
are given and until the day of hCG (Ovitrelle, Serono, Switzerland) injection. Gonadotropin
stimulation will consist of recombinant FSH (Gonal F, Serono, Postfach, Switzerland; or
Puregon, N.V. Organon, Oss, The Netherlands), alone or in combination with urinary
gonadotropins (Menopur, Ferring, Kiel, Germany). During treatment, the ovarian response will
be monitored by serial vaginal ultrasound measurements of follicular growth and serum E2
level every 1-3 days, starting on the fourth or fifth day of stimulation, gonadotropin dosage
will be adjusted accordingly. When at least 3 follicles reached at least 17 millimeters, hCG
is injected and thirty six hours after hCG injection, follicles will be aspirated in the
operating room.
Data Collection:
Recorded data will include:
Cardiac Output and its derivate including: systolic blood pressure (SBP), diastolic
blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), stroke volume (SV),
cardiac output (CO) and total peripheral resistance (TPR).
Demographic and obstetric age, weight, height, current hemoglobin, comorbidities,
regular medication and other obstetric data.
Data Handling Data collection for all participants in the study will be done anonymously. All
hemodynamic data collected will be done by a trained member of the research team. All
collected data will be coded and recorded on the eCRF NICaS monitor, and will be accessible
only to a member of the research team.
Study duration:
The study duration for each participant will be throughout the IVF cycle of treatment
approximately 6 weeks.
