Evidence map›Paper›PMID 33931123›Full record

ArticleFertility research and practice2021

Reducing day 3 baseline monitoring bloodwork and ultrasound for patients undergoing timed intercourse and intrauterine insemination treatment cycles.

Victoria O'Driscoll, Ilinca Georgescu, Irene Koo, Rebecca Arthur, Rita Chuang, Jillian Ann Dempsey, Giulia De Franco, Claire Ann Jones

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Fertility research and practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 95% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Victoria O'DriscollUniversity of Toronto, Undergraduate Medical Education, 1 King's College Circle, Room 3157, Toronto, ON, M5S 1A8, Canada. Victoria.odriscoll@mail.utoronto.ca.ORCID http://orcid.org/0000-0001-6133-5320
Ilinca GeorgescuSchulich School of Medicine & Dentistry, Western University, 1151 Richmond Street, London, ON, N6A 5C1, Canada.
Irene KooDepartment of Obstetrics and Gynaecology, University of Toronto, 123 Edward Street, Suite 1200, Toronto, ON, M5G 1E2, Canada.
Rebecca ArthurDepartment of Obstetrics and Gynaecology, University of Toronto, 123 Edward Street, Suite 1200, Toronto, ON, M5G 1E2, Canada.
Rita ChuangDepartment of Obstetrics and Gynaecology, University of Toronto, 123 Edward Street, Suite 1200, Toronto, ON, M5G 1E2, Canada.
Jillian Ann DempseyMount Sinai Fertility, Sinai Health System, 250 Dundas Street West, Suite 700, Toronto, ON, M5T 2Z5, Canada.
Giulia De FrancoMount Sinai Fertility, Sinai Health System, 250 Dundas Street West, Suite 700, Toronto, ON, M5T 2Z5, Canada.
Claire Ann JonesDepartment of Obstetrics and Gynaecology, University of Toronto, 123 Edward Street, Suite 1200, Toronto, ON, M5G 1E2, Canada.
University of Toronto · CASinai Health System · CAWestern University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the current context of a global pandemic it is imperative for fertility clinics to consider the necessity of individual tests and eliminate those that have limited utility and may impose unnecessary risk of exposure. The purpose of this study was to implement and evaluate a multi-modal quality improvement (QI) strategy to promote resource stewardship by reducing routine day 3 (d3) bloodwork and transvaginal ultrasound (TVUS) for patients undergoing intrauterine insemination (IUI) and timed intercourse (IC) treatment cycles.

methodsAfter literature review, clinic stakeholders at an academic fertility centre met to discuss d3 testing utility and factors contributing to d3 bloodwork/TVUS in IC/IUI treatment cycles. Consensus was reached that it was unnecessary in patients taking oral/no medications. The primary intervention changed the default setting on the electronic order set to exclude d3 testing for IC/IUI cycles with oral/no medications. Exceptions required active test selection. Protocols were updated and education sessions were held. The main outcome measure was the proportion of cycles receiving d3 bloodwork/TVUS during the 8-week post-intervention period compared with the 8-week pre-intervention period. Balancing measures included provider satisfaction, pregnancy rates, and incidence of cycle cancellation.

resultsA significant reduction in the proportion of cycles receiving d3 TVUS (57.2% vs 20.8%, p < 0.001) and ≥ 1 blood test (58.6% vs 22.8%, p < 0.001) was observed post-intervention. There was no significant difference in cycle cancellation or pregnancy rates pre- and post-intervention (p = 0.86). Treatment with medications, cyst history, prescribing physician, and treatment centre were associated with receiving d3 bloodwork/TVUS. 74% of providers were satisfied with the intervention.

conclusionA significant reduction in IC/IUI treatment cycles that received d3 bloodwork/TVUS was achieved without measured negative treatment impacts. During a pandemic, eliminating routine d3 bloodwork/TVUS represents a safe way to reduce monitoring appointments and exposure.

Indexed as

InfertilityIntrauterine inseminationQuality improvementResource stewardshipTimed intercourse

Identifiers

PMID33931123
PMCPMC8085474
OpenAlexW3157316233

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.