Association of ovarian stimulation and embryonic aneuploidy in in vitro fertilization cycles with preimplantation genetic testing: A narrative systematic review
Bibliographic record
Abstract
The impact of gonadotropins used for COS on the rate of embryo aneuploidy in patients without the negative effects of age as a confounding factor, is still a subject of lively debate. We ran a systematic search for studies in MEDLINE, PubMed, Google Scholar and the Cochrane Library. A librarian coordinated the search in December of 2020. We included all original peer-reviewed papers in English, irrespective of study-design. There were no restrictions concerning method of amplification or platform used to analyze the amplified DNA. We used the PICO model to select the study population. We included women/couples submitted to COS for IVF with the intention to genetically analyze her/their embryos through PGT. The primary outcome was the rate of aneuploidy. We used the Newcastle-Ottawa scale (NOS) score to evaluate the quality of the studies included. The search yielded 73 citations, and 14 were eligible for analysis, which included data on 4805 cycles. Media quality NOS score was 8. Although it has been demonstrated that natural cycles are associated with aneuploidy, it does seem that more robust stimulations are indeed associated with a higher proportion of aneuploidy. Nevertheless, a higher response is associated with an increased number of euploid embryos available for transfer, which translates into more embryo-transfer cycles with a prospective higher cumulative live birth rate. Further evidence is needed to ascertain if there is a negative impact of COS, especially at the cellular level.
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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 | 0.006 | 0.036 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.007 |
| Bibliometrics | 0.008 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".