NDLI: Optimal control of dosage decisions in controlled ovarian hyperstimulation

Content Provider	Springer Nature Link
Author	He, Miao Zhao, Lei Powell, Warren B.
Copyright Year	2009
Abstract	In the controlled ovarian hyperstimulation (COH) cycle of the in vitro fertilization-embryo transfer (IVF-ET) therapy, the clinicians observe the patients’ responses to gonadotropin dosages through closely monitoring their physiological states, to balance the trade-off between pregnancy rate and ovarian hyperstimulation syndrome (OHSS) risk. In this paper, we model the clinical practice in the COH treatment cycle as a stochastic dynamic program, to capture the dynamic decision process and to account for each individual patient’s stochastic responses to gonadotropin administration. We discretize the problem into a Markov decision process and solve it using a slightly modified backward dynamic programming algorithm. We then evaluate the policies using simulation and explore the impact of patient misclassification. More specifically, we focus on patients with polycystic ovary syndrome (PCOS) or potential, that is, the patients that tend to be more sensitive to gonadotropin administration.
Starting Page	223
Ending Page	245
Page Count	23
File Format	PDF
ISSN	02545330
Journal	Annals of Operations Research
Volume Number	178
Issue Number	1
e-ISSN	15729338
Language	English
Publisher	Springer US
Publisher Date	2009-05-20
Publisher Place	Boston
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Controlled ovarian hyperstimulation Pregnancy rate OHSS risk Dosage decisions Markov decision process Theory of Computation Combinatorics Operations Research/Decision Theory
Content Type	Text
Resource Type	Article
Subject	Management Science and Operations Research

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