Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep 1;23(1):e12603.
doi: 10.1002/rmb2.12603. eCollection 2024 Jan-Dec.

Development of an AI-based support system for controlled ovarian stimulation

Yoshimasa Asada  1   2 , Tomoya Shinohara  3 , Sho Yonezawa  3 , Tomoki Kinugawa  1 , Emiko Asano  1   2 , Masae Kojima  1   2 , Noritaka Fukunaga  1   2 , Natsuka Hashizume  3 , Yoshiki Hashiba  1 , Daichi Inoue  1 , Rie Mizuno  1 , Masaya Saito  1 , Yoshinori Kabeya  3
Affiliations

Development of an AI-based support system for controlled ovarian stimulation

Yoshimasa Asada et al. Reprod Med Biol. .

Abstract

Purpose: Controlled ovarian stimulation (COS) is vital for IVF. We have developed an AI system to support the implementation of COS protocols in our clinical group.

Methods: We developed two models as AI algorithms of the AI system. One was the oocyte retrieval decision model, to determine the timing of oocyte retrieval, and the other was the prescription inference model, to provide a prescription similar to that of an expert physician. Data was obtained from IVF treatment records from the In Vitro Fertilization (IVF) management system at the Asada Ladies Clinic, and these models were trained with this data.

Results: The oocyte retrieval decision model achieved superior sensitivity and specificity with 0.964 area under the curve (AUC). The prescription inference model achieved an AUC value of 0.948. Four models, namely the hCG prediction model, the hMG prediction model, the Cetrorelix prediction model, and the Estradiol prediction model included in the prescription inference model, achieved AUC values of 0.914, 0.937, 0.966, and 0.976, respectively.

Conclusion: The AI algorithm achieved high accuracy and was confirmed to be useful. The AI system has now been implemented as a COS tool in our clinical group for self-funded treatments.

Keywords: artificial intelligence; in vitro fertilization; oocyte retrieval; ovulation induction; prescriptions.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
AACS architecture. (A) AACS consists of the oocyte retrieval decision model and the prescription inference model. (B) The prescription model has four models: The hMG prediction model, the hCG prediction model, the Cetrorelix prediction model, and the Estradiol prediction model.
FIGURE 2
FIGURE 2
Evaluation of the oocyte retrieval decision model. (A) is the ROC curve of the oocyte retrieval decision model. (B) is the confusion matrix of the model. A confusion matrix is used to evaluate the performance of classification models. (C) is the feature importance of the oocyte retrieval decision model. The 2nd_Lg_Foll_size_R refers to the size calculated using the maximum diameter and its perpendicular diameter for the second largest follicle in the right ovary during the IVF procedure. The Lg_Foll_Diam_L represents the maximum follicle diameter for the largest follicle in the left ovary. The 3rd_Lg_Foll_Diam_R denotes the maximum follicle diameter for the third largest follicle in the right ovary. The 2nd_Lg_Foll_Diam_P_R refers to the diameter perpendicular to the maximum diameter of the second largest follicle in the right ovary. P4 and E2 represent the blood levels of progesterone and estrogen, respectively. The mature_total_Foll_num_diff_R is the calculated difference between the number of mature and immature follicles in the right ovary. The stimdays is the number of days since stimulation began. The Ave_Foll_Diam_L represents the average of the maximum diameter and its perpendicular diameter for the follicles in the left ovary. The Lg_Foll_Diam_R refers to the maximum follicle diameter for the largest follicle in the right ovary.
FIGURE 3
FIGURE 3
Evaluation of the hMG prediction model. (A) is the ROC curve of the hMG prediction model. (B) is the confusion matrix of the hMG prediction model. (C) is the feature importance of the hMG prediction model. The LH, hCG, AMH, FSH features represent the levels of hormones measured during the IVF procedure. The features starting with “prev_” represent the medications prescribed during the previous examination. The Foll_num_R represents the number of follicles observed in the right ovary.
FIGURE 4
FIGURE 4
Evaluation of the hCG prediction model. (A) is the ROC curve of the hCG prediction model. (B) is the confusion matrix of the hCG prediction model. (C) is the feature importance of the hCG prediction model. The LH, hCG, FSH, AMH, E2, P4, features represent the levels of hormones measured during the IVF procedure. The stimdays is the number of days since stimulation began. The features starting with “prev_” represent the medications prescribed during the previous examination. The Lg_Foll_Diam_P_L represents the diameter perpendicular to the maximum diameter of the largest follicle in the left ovary.
FIGURE 5
FIGURE 5
Evaluation of the Cetrorelix prediction model. (A) is the ROC curve of the Cetrorelix prediction model. (B) is the confusion matrix of the Cetrorelix prediction model. (C) is the feature importance of the Cetrorelix prediction model. The stimdays is the number of days since stimulation began. The LH, hCG, AMH, FSH, E2 features represent the levels of hormones measured during the IVF procedure. The features starting with “prev_” represent the medications prescribed during the previous examination. The Foll_num_R represents the number of follicles observed in the right ovary.
FIGURE 6
FIGURE 6
Evaluation of the Estradiol prediction model. (A) is the ROC curve of the Estradiol prediction model. (B) is the confusion matrix of the Estradiol prediction model. (C) is the feature importance of the Estradiol prediction model. The stimdays is the number of days since stimulation began. The LH, E2, hCG, FSH, AMH features represent the levels of hormones measured during the IVF procedure. The features starting with “prev_” represent the medications prescribed during the previous examination. The Lg_Foll_Diam_P_R represents the diameter perpendicular to the maximum diameter of the largest follicle in the right ovary.
See this image and copyright information in PMC

References

    1. Gianaroli L, Racowsky C, Geraedts J, Cedars M, Makrigiannakis A, Lobo R. Best practices of ASRM and ESHRE: a journey through reproductive medicine. Hum Reprod. 2012;27(12):3365–3379. - PubMed
    1. Polyzos NP, Drakopoulos P, Parra J, Pellicer A, Santos‐Ribeiro S, Tournaye H, et al. Cumulative live birth rates according to the number of oocytes retrieved after the first ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection: a multicenter multinational analysis including ∼15,000 women. Fertil Steril. 2018;110(4):661–670.e1. 10.1016/j.fertnstert.2018.04.039 - DOI - PubMed
    1. Vaughan DA, Leung A, Resetkova N, Ruthazer R, Penzias AS, Sakkas D, et al. How many oocytes are optimal to achieve multiple live births with one stimulation cycle? The one‐and‐done approach. Fertil Steril. 2017;107(2):397–404.e3. - PubMed
    1. Asada Y, Tokoro M, Sonohara M, Fukunaga N, Hattori Y, Hashiba Y. Long‐term outcomes of freeze‐all strategy: a retrospective analysis from a single ART center in Japan. Reprod Med Biol. 2019;18(2):173–179. - PMC - PubMed
    1. National Institute for Health and Care Excellence . Fertility problems: assessment and treatment. Published: 2013 Feb. https://www.nice.org.uk/guidance/cg156/chapter/recommendations - PubMed

LinkOut - more resources