(361g) Differentiating between FSH and HMG Dosage for Personalized Modeling of Superovulation in IVF Patients

In-vitro fertilization, or IVF, is a treatment for infertility where an embryo is formed in the lab with an egg and sperm sample and then placed in the uterus. It is typically reserved for when other treatments, such as fertility drugs, surgery, and artificial insemination, have failed. The four stages are superovulation, egg retrieval, fertilization, and embryo transfer. Superovulation is when medications are administered to control the timing and intensity of ovulation to produce enough follicles that can feasibly be retrieved for a successful IVF cycle. The two most commonly used medications are FSH and HMG hormones, both of which stimulate ovulation. Currently, the dosage during superovulation is not patient-specific, resulting in complications like overstimulation. To optimize dosage for each patient, Dr. Urmila Diwekar’s group has developed a mathematical procedure to provide a customized model for follicle size distribution (FSD) as a function of the drugs used and conditions imposed on the patient that can then predict future outcomes. Optimal drug dosage decisions model uncertainty and risk. However, the current procedure models FSD as a function of the dosage of only FSH. Assuming half of HMG contains FSH, the prescribed FSH dosage for every patient is determined by adding the dosage of pure FSH to half of the dosage of HMG.

Our current endeavor is to eliminate the use of this assumption and develop a similar mathematical approach that differentiates between the separate doses of FSH and HMG. The procedure will model FSD as a function of FSH dosage, HMG dosage separately and the conditions imposed on the patient. The new model considers reactions of HMG, which also contains LH apart from FSH with the follicles. The procedure is corroborated using clinical data from 100 patients who previously underwent IVF cycles. In the end, our goal is for the results to validate the use of the modified procedure to optimize drug dosage during IVF more specifically.