Natural Pregnancy Following Oocyte Retrieval in a Luteal-Phase Progestin-Primed Ovarian Stimulation (PPOS) Protocol With Concurrent Blastocyst Cryopreservation: A Case Report
Bibliographic record
Abstract
Ovarian stimulation is used in assisted reproductive technology to help infertile couples achieve pregnancy. Luteal-phase stimulation with progestin-primed ovarian stimulation (PPOS) is a practical approach, as it involves oral medication with fewer daily injections compared to gonadotropin-releasing hormone (GnRH) agonist or GnRH antagonist protocols. Unintended pregnancy during ovarian stimulation or after oocyte pick-up (OPU) is rare but possible. We present the case of a 38-year-old patient with secondary infertility, known to have endometriosis, chronic inflammatory demyelinating polyneuropathy, and low ovarian reserve. She initially underwent ovarian stimulation with an antagonist protocol, which was later switched to luteal-phase PPOS to improve synchronization. For ovulation induction to initiate luteal-phase stimulation, the patient received human chorionic gonadotropin (hCG). A pregnancy test performed during ovarian stimulation yielded a result consistent with exogenous hCG administration. On the day of OPU, a corpus luteum was observed in the right ovary, and two follicles were present in the left ovary. OPU resulted in the retrieval of one oocyte, which developed into a blastocyst and was subsequently cryopreserved. A natural pregnancy was detected by hCG testing 10 days after OPU, prompted by a delayed menstrual cycle and the corpus luteum observed during OPU. Transvaginal ultrasound confirmed an intrauterine pregnancy with a positive fetal heartbeat. This case highlights the importance of considering the possibility of pregnancy even after luteal-phase PPOS and OPU, taking into account both the patient's clinical context and laboratory findings.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.006 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".