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We present an overview of the current status of the European collaborative
project PAEON. The challenge of PAEON is to provide specialists in reproduc-
tive medicine with a computerised model of the menstrual cycle under normal
and various pathological conditions, which will allow them to get further in-
sight in fertility dynamics. This model also enables the simulation of treatment
protocols, which were used within in vitro fertilization. By the definition of
virtual patients through biologically admissible parametrizations our approach
allows not only the evaluation of a given treatment strategy in silico, but also
the design and optimization of such protocols. Once a protocol is formalized
in the virtual hospital, the success can be controlled by a treatment execution
monitor, which works then as a clinical decision support system. All these tools
will be combined in a virtual hospital environment, enabling the access to the
PAEON services through the web.
Mathematical Modelling and Simulation Provides Evidence for New Strategies of Ovarian Stimulation
(2021)
New approaches to ovarian stimulation protocols, such as luteal start, random start or double stimulation, allow for flexibility in ovarian stimulation at different phases of the menstrual cycle which is especially useful when time for assisted reproductive technology is limited, e.g. for emergency fertility preservation in cancer patients.
It has been proposed that the success of these methods is based on the continuous growth of multiple cohorts ("waves") of follicles throughout the menstrual cycle which leads to the availability of ovarian follicles for ovarian controlled stimulation at several time points. Though several preliminary studies have been published, their scientific evidence has not been considered as being strong enough to integrate these results into routine clinical practice. This work aims at adding further scientific evidence about the efficiency of variable-start protocols and underpinning the theory of follicular waves by using mathematical modelling and numerical simulations. For this purpose, we have modified and coupled two previously published models, one describing the time course of hormones and one describing competitive follicular growth in a normal menstrual cycle. The coupled model is used to test stimulation protocols in silico. Simulation results show the occurrence of follicles in a wave-like manner during a normal menstrual cycle and qualitatively predict the outcome of ovarian stimulation initiated at different time points of the menstrual cycle.