Minimal Stimulation Using Letrozole in Poor Responders
Bibliographic record
Abstract
Background: Poor responders refer to women who undergo ovarian stimulation with suboptimal response and an optimal treatment for them has yet to be proven. Minimal stimulation which uses lower doses of gonadotropins than standard long protocols had been shown to yield fewer but higher quality embryos. Minimal stimulation had thus been proposed as an option for poor responders who do not benefit from longer and higher cost regimens. The aim of this retrospective study was to evaluate outcomes of poor responders who underwent minimal stimulation using letrozole and whether they are comparable to outcomes of conventional in vitro fertilization (IVF) in a tertiary center in Singapore. Methods: This was a retrospective study of 43 poor responders who underwent minimal stimulation protocol in KK Women Women’s and Children Women’s Hospital IVF center between March 2011 and March 2014. The protocol involved sequential administration of letrozole followed by low-dose gonadotropins and a gonadotropin-releasing hormone (GnRH) antagonist. Primary outcomes included clinical pregnancy rate and live birth rate per patient. A subgroup analysis was done for women undergoing minimal stimulation protocol and having failed conventional IVF protocol in which their outcomes were compared. Results: The average age at time of stimulation was 38.6 years old. Clinical pregnancies were achieved in nine women (20.9%), out of which eight (18.6%) were live births. In the subgroup analysis, cleavage rate obtained in the minimal stimulation protocol was significantly higher at 61.3% compared to the cleavage rate obtained in the conventional IVF cycle at 28.7%. There were no significant differences in the pregnancy and live birth rates of the two cycles. Conclusion: Minimal stimulation protocol using letrozole produces a reasonable live birth rate in poor responders and potentially higher quality oocytes than conventional IVF protocol. J Clin Gynecol Obstet. 2019;8(3):77-80 doi: https://doi.org/10.14740/jcgo557
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".