Will non-Ultrasound Monitoring Ovarian Stimulation (NUMOS) Make Freeze all for all? - cost-Effectiveness Analysis

Assisted reproductive technologies are one of the most rapidly developing fields in medicine. In recent decades, new technologies and methods have been introduced that have made it possible to increase the success rate of infertility treatment and reduce its costs. Using the vitrification method, it has become feasible to successfully freeze oocytes and embryos, with the freeze-all embryos strategy becoming increasingly popular, as it presents a high success rate, various clinical advantages, and reduced patient risk, especially for patients with a high ovarian response. A major challenge with this strategy, compared to the generally accepted classic approach for the so-called fresh embryo transfer, is the additional costs resulting from freezing/thawing the embryos and the additional visits related to preparation for embryo transfer. A solution to this problem would be to use the non-ultrasound monitoring of ovarian stimulation (NUMOS) approach, allowing to significantly reduce the costs of infertility treatment through IVF procedure, the direct medical and non-medical costs, as well as the indirect costs. NUMOS in combination with progestin (PPOS) is an appropriate protocol when applying the freeze-all strategy. This method also enables the active entry of artificial intelligence (AI) into the treatment process. It is anticipated to usher a shift in the established paradigm in medicine, which should not be seen as a revolution, but rather as part of an evolutionary process.