The Alignment Paradox of Medical Large Language Models in Infertility Care: Decoupling Algorithmic Improvement From Clinical Decision-Making Quality

Dou Liu   ^{1, 2, 3 *} , BSc ;   Ying Long   ^{1, 3, 4 *} , MD ;   Sophia Zuoqiu   ⁵ , PhD ;   Di Liu   ^{5, 6, 7} , PhD ;   Kang Li   ^{6, 7} , PhD ;   Kaipeng Xie   ⁵ , BSc ;   Runze Yang   ⁵ , BSc ;   Yiting Lin   ⁸ , MBBS ;   Hanyi Liu   ⁸ , MBBS ;   Rong Yin   ^{5, 6, 7 *} , PhD ;   Tian Tang   ^{1, 3, 4 *} , MD

¹ Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China

² Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI, United States

³ Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, Sichuan, China

⁴ Reproductive Medical Center, Department of Obstetrics and Gynecology, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China

⁵ Department of Industrial Engineering, Sichuan University, Chengdu, Sichuan, China

⁶ West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China

⁷ Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, China

⁸ West China School of Medicine, Sichuan University, Chengdu, Sichuan, China

*these authors contributed equally