Live birth after transmyometrial embryo transfer in a patient with radical trachelectomy
Bibliographic record
Abstract
OBJECTIVE: To report the successful utilization of transmyometrial embryo transfer (TMET) in a patient with a history of radical trachelectomy. DESIGN: Video article. SETTING: Academic fertility center. PATIENT(S): A 39-year-old, para 1, woman with a history of radical trachelectomy and abdominal cerclage presented with secondary infertility. Her previous pregnancy was conceived naturally. Her first in vitro fertilization (IVF) cycle yielded only one day 7 euploid blastocyst. All attempts at performing mock embryo transfers, cervical dilatation, and hysteroscopy were unsuccessful because of absence of clinically identifiable cervical tissue. The euploid embryo was transferred into a gestational carrier; however, this resulted in a biochemical pregnancy. She underwent a second IVF cycle that yielded one day 5 euploid blastocyst. Given her history, TMET was planned. The patient included in this video gave consent for publication of the video and posting of the video online including social media, the journal website, scientific literature websites (e.g., PubMed, ScienceDirect, and Scopus) and other applicable sites. INTERVENTION(S): Transmyometrial embryo transfer using the Towako catheter. MAIN OUTCOME MEASURE(S): Implantation, clinical pregnancy, and live birth. RESULT(S): After institutional and Health Canada approval of the Towako catheter, a transvaginal ultrasound-guided TMET was performed under sedation with intravenous midazolam and fentanyl. The day 5 euploid blastocyst from the second IVF cycle was transferred, and the patient's β-human chorionic gonadotropin levels 9 and 11 days after TMET were 86 and 262 IU/L, respectively. A single intrauterine pregnancy with cardiac activity of 119 beats/min was noted at a gestational age of 7 weeks and 2 days. The patient delivered a live singleton at 35 weeks and 2 days weighing 2,182 g. CONCLUSION(S): Transmyometrial embryo transfer is a useful clinical technique for transferring embryos in patients with acquired or congenital cervical issues in whom transcervical embryo transfer is either very difficult or impossible.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| 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 teacher head, 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".