ABSTRACT
In 2006, the Royal College of Obstetricians and Gynaecologists (RCOG) and the National Institute for Clinical Excellence (NICE) both state that ultrasound (US) monitoring is essential during treatment with CC. However, a systematic review of Galazis et al. from 2007 (8) found that there was insufficient evidence to suggest that US monitoring improved pregnancy rates or reduced multiple pregnancy rates. There was, on the other hand, no indication that treatment with CC is safe without US monitoring. No reliable conclusions could be drawn because of the small number of relevant studies and the heterogeneity in the methodology of each study (LOE 1a). In 2013, the NICE guideline (9) advised to offer US monitoring in CC treatment during at least the first cycle of treatment, to ensure a dose that minimizes
ovarian hyper stimulation (LOE 4).
