Here’s what happened:

“You might be a reproductive endocrinologist overseeing an IVF cycle. The patient is a 35-year-old female with tubal factor infertility. Sperm counts for her male partner are normal. Her AMH level is normal for her age group and thyroid and prolactin testing are all normal. She had undergone one previous stimulation with down regulation using a GnRH agonist starting within the previous menstrual cycle through the luteal phase, followed by stimulation with 225 iu of recombinant FSH once a day. Egg retrieval yielded three oocytes. The fertilized and one progressed to blastocyst stage and was transferred on day 5. Pregnancy test was negative. What stimulation regimen do you recommend?”

chatGPT’s suggestion:

Based on the knowledge provided, the patient has tubal factor infertility and has undergone one previous stimulation cycle with down regulation using a GnRH agonist followed by stimulation with recombinant FSH. Only three oocytes were retrieved and just one progressed to the blastocyst stage, leading to a negative pregnancy test.

For the following stimulation cycle, the next recommendations may very well be made:

1. Adjust the dosage of FSH: The present dosage of 225 iu of recombinant FSH once a day will not be optimal for this patient. The dosage may very well be adjusted based on the patient’s response to the previous stimulation cycle.
2. Think about using a GnRH antagonist: A GnRH antagonist could also be a more sensible choice than a GnRH agonist for this patient, as it could prevent premature LH surges that might impact oocyte quality.
3. Use a gentle stimulation protocol: For the reason that patient only yielded three oocytes within the previous cycle, a gentle stimulation protocol may very well be considered. This involves using lower doses of FSH and reducing the duration of ovarian stimulation.
4. Consider adding a complement to enhance oocyte quality: Coenzyme Q10 (CoQ10) may improve oocyte quality and may very well be regarded as a complement through the next cycle.
5. Think about using ICSI: For the reason that male partner’s sperm counts are normal, using Intracytoplasmic Sperm Injection (ICSI) may improve fertilization rates and embryo development.

Overall, it can be crucial to individualize the stimulation protocol based on the patient’s response to previous cycles and other aspects resembling age and ovarian reserve. Close monitoring through the cycle can also be necessary to regulate the protocol as needed.

I used an agonist protocol to see if the AI system would recommend switching to an antagonist, which it did instantly. Then I asked the identical query, using that protocol:

Based on the knowledge provided, the patient has tubal factor infertility and has undergone one previous stimulation cycle using a GnRH antagonist protocol and 225 iu of recombinant FSH once a day, leading to only three oocytes retrieved and one blastocyst transferred with a negative pregnancy test. For the following stimulation cycle, the next recommendations may very well be made:

1. Adjust the dosage of FSH: The present dosage of 225 iu of FSH once a day will not be optimal for this patient. The dosage may very well be adjusted based on the patient’s response to the previous stimulation cycle.
2. Use a distinct variety of gonadotropin: A distinct variety of gonadotropin resembling highly purified FSH, or a mixture of FSH and LH, could also be considered to enhance ovarian response.
3. Think about using a gentle stimulation protocol: For the reason that patient had a poor response to the previous stimulation cycle, a gentle stimulation protocol may very well be considered. This involves using lower doses of FSH and reducing the duration of ovarian stimulation.
4. Use a distinct trigger for final oocyte maturation: The previous protocol could have impacted oocyte quality, so a distinct trigger for final oocyte maturation may very well be considered, resembling using a mixture of GnRH agonist and HCG or solely using HCG.
5. Think about using a complement to enhance oocyte quality: Coenzyme Q10 (CoQ10) may improve oocyte quality and may very well be regarded as a complement through the next cycle.
6. Consider preimplantation genetic testing: Preimplantation genetic testing for aneuploidy (PGT-A) could also be considered for the embryos with a purpose to select one of the best embryos for transfer, which could increase the possibilities of a successful pregnancy.
7. Ensure good overall health and fertility optimization: Lifestyle modifications resembling maintaining a healthy body weight, quitting smoking, and reducing alcohol intake, may very well be encouraged to optimize fertility.

Overall, it can be crucial to individualize the stimulation protocol based on the patient’s response to previous cycles, age, and ovarian reserve. Close monitoring through the cycle can also be necessary to regulate the protocol as needed.

AI isn’t able to graduate from fellowship yet (and clearly must do some more reading on stimulation protocols) but, given the self-teaching nature of machine learning, the identical query asked 6 months or a 12 months from now will likely give more clinically appropriate answers, and a 12 months later could also be experienced-RE equivalent.

When you’re developing AI solutions, you’re prone to be asked what differentiates what you’re doing from currently accessible systems which are available at minimal to no cost to the user.