A BMI above the normal range was an independent negative prognostic factor for multiple outcomes, including cycle cancellation, oocyte and embryo counts, and OCP. These negative outcomes were most profound in women with class-II/III obesity, ovulatory dysfunction, or PCOS.
The degree of exposure to exogenous gonadotropins did not significantly modify the likelihood of aneuploidy in patients with a normal ovarian response to stimulation (not requiring COH beyond cycle day 12). Patients requiring prolonged COH were demonstrated to have elevated odds of aneuploidy with increasing cumulative gonadotropin dose. This finding may reflect an increased tendency towards oocyte and embryonic aneuploidy in patients with a diminished response to gonadotropin stimulation.
Significant progress has been made in several fields of medicine towards personalizing treatment recommendations based on individual patient genotype. As the number of clinical and genetic biomarkers available to physicians has increased, predictive models able to integrate the contributions of multiple variables simultaneously have become valuable tools for medical decision making. Leveraging genotype information and multivariate predictive models holds the promise of bringing greater efficiency to, and reducing the costs of, fertility treatments. This work reviews the advances that have been made in genetic biomarker discovery and predictive modelling for fertility treatment outcomes. We also discuss some of the limitations of these studies for translation to clinical diagnostics and the challenges that remain.Personalized medicine holds the promise of allowing doctors to create 'bespoke' treatment recommendations for each patient based on multiple clinical variables such as age and hormone concentrations combined with the patient's genetic sequence information. A number of challenges remain for the field of reproductive medicine to make the research discoveries necessary to usher in this new era of personalized fertility care. Here, we discuss some of these challenges and make recommendations for overcoming them.
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