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Evaluating the concordance between AI-based and conventional embryo selection: implications for clinical

Piotr Wygocki1, Tomasz Gilewicz2, Paweł Pawlik2

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Artificial intelligence (AI) shows promise in standardizing embryo scoring. An embryo selection algorithm (ESA) demonstrated higher accuracy than most human embryologists, suggesting its potential to improve pregnancy outcomes.

Keywords:
Artificial intelligenceDeep learningEmbryo developmentEmbryo selection algorithmPregnancy prediction

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Area of Science:

  • Reproductive medicine
  • Artificial intelligence in healthcare
  • Embryology

Background:

  • Standardized embryo scoring is crucial for improving in vitro fertilization (IVF) success rates.
  • Current methods rely on subjective interpretation by embryologists, leading to variability.
  • Identifying embryos with the highest potential for pregnancy and live birth remains a challenge.

Purpose of the Study:

  • To evaluate the accuracy of an artificial intelligence (AI) embryo selection algorithm (ESA) in identifying viable embryos.
  • To compare the ESA's performance against human embryologists in embryo scoring.
  • To determine if AI can standardize embryo assessment and improve pregnancy prediction.

Main Methods:

  • A multicentre, retrospective analysis involving six centers across five countries.
  • An ESA and 20 embryologists independently assessed 1681 embryo pairs.
  • Accuracy was calculated for the ESA and each embryologist, with differences analyzed using McNemar's test.

Main Results:

  • The ESA achieved an accuracy of 70.1% in selecting the best embryo.
  • Individual embryologists' accuracy ranged from 64.2% to 68.9%, with a mean of 67.7%.
  • The ESA showed a statistically significant advantage over 14 out of 20 embryologists and the mean embryologist accuracy.

Conclusions:

  • The ESA demonstrated superior accuracy compared to the majority of individual embryologists and the average performance.
  • AI has the potential to serve as a standardized tool to augment expert embryologist judgment.
  • Further prospective, multicenter trials are necessary to confirm the ESA's effectiveness and generalizability in clinical practice.