Session 44: IVM and culture
Bibliographic record
Abstract
The results of a prospective trial comparing the cumulative ongoing pregnancy rate (OPR) over a given period of time (12 months) between standard and mild IVF are presented.Material and Methods: Starting in January 2008, two different strategies were offered to good prognosis patients (age 38 yrs, normovulatory, no severe male factor( entering ART for the first time: A) conventional cycle performed with standard GnRH analogues protocolsþ rFSH and regular monitoring.Oocytes cryopreservation of surplus oocytes was offered.B) IVF Lite intended as a package of three cycles performed with a fixed mild stimulation: clomiphene citrate 100 mg/day from day 3 to day 7 plus 150 IU of FSH on day 5,7 and 9. Monitoring of the cycle from day 8 to time GnRH antagonist administration.No oocyte cryopreservation was offered.The new approach was designed to reduce time, costs, discomfort and complications and, therefore, to let the patients to repeat treatments in shorter times.Patients were clearly informed that the delivery rate per cycle using the conventional approach was established since many years (25-30%), while the new approach was experimental because no data were available at the time.However, the primary end point was not to compare cycle results, but the cumulative OPR / patient obtained over a given period of time.Results: Out of 137 patients entering the criteria for selection, 112 preferred the conventional approach (group A( and only 25 accepted to enter IVF Lite (group B).The mean age and the infertility factors were similar in the two groups.Results after 12 months are:-group A: 31 ongoing pregnancies from the 1st cycle (27 with fresh transfers and 4 from 25 thawing cycles(; 20 non pregnant patients performed a 2nd cycle, obtaining 6 additional pregnancies (5 fresh and 1 thawing).-group B: 7 ongoing pregnancies in the first cycle, 5 in 11 non pregnant patients performing a second cycle and 1 pregnancy in 2 patients performing the 3rd cycle.The cumulative OPR is 33% (37/112) in group A and 52% (13/25) in group B (X 2 ¼ 2.4).As expected, the amount of FSH utilized, the estradiol levels and the number of collected oocytes resulted significantly lower in group B. The fresh PR per embryo transfer was 32% in group A and 48% in group B (n.s.); the implantation rate 19% in group A and 25% in group B (n.s.).Details will be presented, but the first aim of the study is not to compare different stimulations but different approaches.Discussion: Using for insemination a max of 3 eggs in all cycles, as imposed in Italy, mild approaches can reduce costs and time to pregnancy.The preliminary results seem also to demonstrate that minimal stimulations are non inferior to standard protocols in good prognosis patients.As recommended by several Authors, it is time to test mild approaches to IVF.Good prognosis patients can have benefits not only in countries, like Italy, where embryo selection is not allowed, but all over the world.
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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 | 0.004 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.054 | 0.015 |
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".