EXTERNAL VALIDATION OF AN AI SYSTEM FOR BLASTOCYST IMPLANTATION PREDICTION

Objective

To assess the performance in a clinical setting of IVFvision.ai, an artificial intelligence (AI) system for blastocyst selection

Design

Retrospective analysis of single blastocyst transfer (SBT) images

Materials and Methods

Convolutional Neural Networks were used to develop IVFvision.ai, an algorithm that differentiates between Day-5 blastocysts with a positive or negative implantation outcome. Implantation was confirmed by the presence of an embryonic sac with heartbeat.

External validation of IVFvision.ai was performed at a University IVF Clinic using 113 anonymised Embryoscope images of SBT. Assessed images were taken at 116±h hours post-insemination at the equatorial focal plane.

The predictive ability and reliability of IVFvision.ai to correctly classify blastocysts according to implantation outcome were compared to the KIDScoreD5 v2 prediction algorithm, as well as three expert Clinical Embryologists.

AUC for each predictor was estimated using ROC curve analysis. Sensitivity, specificity, PPV, NPV and accuracy were calculated using crosstabs. Reliability of IVFvision.ai and embryologist assessments was calculated by the Interclass correlation coefficient (ICC). Stepwise logistic regression was used to model predictors significantly associated with implantation controlling for maternal age and fertilisation method.

Results

IVFvision.ai had higher AUC and overall accuracy in predicting implantation compared to KIDScoreD5 and all embryologists (Table 1). The reliability of IVFvision.ai was perfect (ICC = 1.00, 95% CI 1.00 to 1.00), consistently returning the same classification after a triple reading process. The reliability between 3 embryologists was moderate (ICC = 0.744, 95% CI 0.606 to 0.838), significantly lower than that of IVFvision.ai.

Stepwise logistic regression showed that only IVFvision.ai prediction (p=0.008) and fertilisation method (p=0.051) were significantly associated with implantation. The combined model IVFvision.ai+Fert had an AUC 0.740.

Conclusions

IVFvision.ai is a comprehensive AI system that identifies implantation outcome with high ability, outperforming all human experts and the KIDScore prediction algorithm. The system paves the way for clinical trials to improve the accuracy and efficiency of embryo selection in IVF.

Article Info

Publication History

P-82 4:30 PM Saturday, October 17, 2020

Identification

DOI: https://doi.org/10.1016/j.fertnstert.2020.08.413

URL: https://www.fertstert.org/article/S0015-0282(20)31167-5/fulltext#%20