Automating External Record Review in Reproductive Endocrinology

Background

Terra Fertility, a comprehensive fertility network offering IVF, IUI, egg freezing, donor cycles, and reproductive endocrinology services, treats an increasingly complex patient population. Many individuals arrive with years of OB/GYN care, prior fertility workups, multiple treatment attempts, or significant comorbidities.

For REIs, the quality of clinical decisions - protocol selection, med dosing, cycle timing, transfer planning - depends on having a complete and accurate understanding of each patient’s history:

• Ovarian reserve trends (AMH, AFC, FSH, estradiol patterns)
• Prior stimulation protocols and responses
• Embryology outcomes (fertilization rates, blast development, PGT results)
• Surgical history and its effect on uterine/tubal factors
• Endocrine or autoimmune conditions affecting cycle performance
• Imaging findings (HSG/SHG, saline sonograms, MRIs)
• Male factor variables
• Genetic risks or oncology history

But these data were almost always buried in 200–600 pages of external records making it difficult for clinicians to access what they needed before key decisions.

The Clinical Challenge

Fertility clinicians must form highly individualized treatment plans. Yet essential clinical details were often difficult to extract quickly, leading to:

1. Incomplete visibility into past cycle responses

• Without an accurate history, providers risked repeating unsuccessful stimulation strategies or overlooking subtle ovarian performance patterns.

2. Missed details with significant clinical impact

• Examples include:
  • Prior ectopic pregnancies
  • Hidden operative notes describing endometriosis or tubal pathology
  • Previous thin-lining cycles
  • Undocumented male factor issues
  • Thyroid, autoimmune, or prolactin abnormalities

3. Delayed or suboptimal protocol selection

• Clinicians needed immediate clarity on whether a patient responded well to antagonist protocols, required microdose flare, or had previous OHSS risks.

4. Reduced confidence during consultations

• REIs often spent 20–30 minutes per visit searching through PDFs instead of counseling patients.

5. Coordination challenges across the care team

• Nurses, embryologists, and patient navigators all relied on the same historical insight yet struggled with fragmented data.

Ultimately, the bottleneck wasn’t clinical expertise, it was access to the right information at the right time.

The Solution: Abstractive Health’s Automated Clinical Summarization for Fertility Medicine

Terra Fertility implemented Abstractive Health, enabling automatic extraction, structuring, and summarization of external medical records specifically for clinical decision making.

Instead of reviewing hundreds of pages, clinicians were presented with an AI-generated clinical profile cutting external record review time by ~60% and enabling same-day protocol decisions such as:

1. Ovarian reserve & hormonal trends

• AMH, FSH, estradiol, LH, progesterone, TSH, prolactin, and other endocrine markers, all critical for predicting response and tailoring protocols.

2. Prior fertility treatments & outcomes

• Stimulation protocols used
• Medication dosages
• Follicular development
• Oocyte yield
• Fertilization rates
• Blast development
• PGT findings

This allowed for true pattern recognition over time.

3. Surgical and reproductive history relevant to implantation and ovarian function

• Including fibroids, endometriosis staging, tubal factors, ovarian cyst surgeries, and hysteroscopy findings.

4. Imaging summaries

• Concise interpretations of HSG, SHG, pelvic ultrasounds, and MRIs, central to embryo transfer planning.

5. Male partner assessments

• Semen analyses, motility/morphology trends, urology consults, and prior interventions.

6. Genetic and oncology considerations

• Revealing risks that must guide counseling and treatment strategy.

7. Highlighted clinical flags

• For rapid attention to issues such as:
• Repeated thin endometrium
• DOR progression
• Luteal phase concerns
• Prior OHSS
• Medication contraindications

With Abstractive, clinicians finally had the full clinical picture summarized, structured, and instantly accessible.

Clinical Impact

1. More Precise and Confident Protocol Selection

By understanding historical ovarian response patterns, clinicians more reliably identified when to use:

• Antagonist vs. flare protocols
• Adjusted gonadotropin dosing
• Adjuncts like growth hormone or letrozole
• Freeze-all strategies for OHSS prevention

This led to better-aligned stimulation plans and reduced guesswork.

2. Improved Diagnostic Accuracy

Subtle but essential findings such as autoimmune thyroid markers, male factor fluctuations, or previously undocumented uterine pathology—were surfaced automatically.

Clinicians reported feeling more assured that nothing critical was being missed.

3. Faster and Higher-Quality Consultations

Clinical prep time dropped by ~50-60%, allowing REIs to walk into consults with complete histories, structured summaries, and prioritized clinical flags.

This translated into 15–30 minutes saved per consult, more focused patient conversations, and faster initiation of treatment plans.

4. Stronger Cross-Team Coordination

Embryologists, nurses, and navigators accessed the same structured summaries, improving:

Cycle planning

• Lab monitoring
• Pre-transfer reviews
• Embryology decision-making
• Communication with patients

The entire care team operated with a single source of truth.

5. Reduced Risk & Higher Clinical Confidence

By ensuring that prior surgical findings, endocrine trends, and past cycle outcomes were never overlooked, Abstractive helped reduce errors and strengthen clinical judgment.

For high-stakes decisions—like timing retrieval, choosing transfer strategy, or recommending donor eggs—the increased clarity was invaluable.

Conclusion

By automating the synthesis of complex external records, Terra Fertility transformed the way clinicians prepare for and deliver care. Abstractive enabled:

• More precise diagnostics
• Smarter protocol selection
• Faster consults
• Stronger team coordination
• Higher confidence in every clinical decision

In a specialty where outcomes depend on understanding every detail of a patient’s history, Abstractive provides Terra Fertility with the clarity clinicians need and the efficiency patients deserve.