Safety and Efficacy of <i>in Vitro</i> Fertilization in Women with Systemic Lupus Erythematosus and Antiphospholipid Syndrome
Bibliographic record
Abstract
Systemic lupus erythematosus (SLE) is a chronic, multisystem, hormone-sensitive autoimmune disease that can be associated with antiphospholipid syndrome (APS). The prevalence of SLE ranges from 40 to 200 cases per 100,000 persons, depending on ethnic background, and it predominantly affects women of childbearing age. The prognosis of SLE has dramatically improved in recent decades. In the 1950s, 50% of patients with SLE survived more than 4 years, and today, the 15-year survival rate is over 80%1. With improved outcomes, the possibility of conceiving and bearing children is becoming a reality for many women with SLE. Despite increased risks of flares, thrombosis, and gestational complications such as preeclampsia, most women with treated and clinically quiescent SLE can safely carry a pregnancy under appropriate medical supervision2. Infertility rates in SLE, with some exceptions, are similar to those of the general population3, and claims that antiphospholipid antibodies (aPL) could contribute to infertility are largely unsubstantiated4. Because SLE is an estrogen-sensitive disease, hormonal manipulation carries an inherent risk of SLE flares, hypercoagulability, and ovarian hyperstimulation syndrome (OHSS). Further, the safety of assisted reproductive technology (ART) has not been clearly established in patients with SLE/APS5. The relative paucity of data on the subject is explained by the rarity of concomitant SLE and infertility, but with an increasing number of young women achieving disease quiescence, the topic becomes increasingly relevant. There are rare documented case reports of severe, and 1 fatal SLE/APS exacerbation after ovulation induction (OI)6,7,8. However, only 2 series on ART in patients with SLE have been published to … Address correspondence to Dr. C.A. Laskin, TRIO Fertility, 655 Bay St., 18th Floor, Toronto, Ontario M5G 2K4, Canada. E-mail: calaskin{at}gmail.com
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".