Consistency and objectivity of automated embryo assessments using deep neural networks.

Abstract:

OBJECTIVE:To evaluate the consistency and objectivity of deep neural networks in embryo scoring and making disposition decisions for biopsy and cryopreservation in comparison to grading by highly trained embryologists. DESIGN:Prospective double-blind study using retrospective data. SETTING:U.S.-based large academic fertility center. PATIENTS:Not applicable. INTERVENTION(S):Embryo images (748 recorded at 70 hours postinsemination [hpi]) and 742 at 113 hpi) were used to evaluate embryologists and neural networks in embryo grading. The performance of 10 embryologists and a neural network were also evaluated in disposition decision making using 56 embryos. MAIN OUTCOME MEASURES:Coefficients of variation (%CV) and measures of consistencies were compared. RESULTS:Embryologists exhibited a high degree of variability (%CV averages: 82.84% for 70 hpi and 44.98% for 113 hpi) in grading embryo. When selecting blastocysts for biopsy or cryopreservation, embryologists had an average consistency of 52.14% and 57.68%, respectively. The neural network outperformed the embryologists in selecting blastocysts for biopsy and cryopreservation with a consistency of 83.92%. Cronbach's α analysis revealed an α coefficient of 0.60 for the embryologists and 1.00 for the network. CONCLUSIONS:The results of our study show a high degree of interembryologist and intraembryologist variability in scoring embryos, likely due to the subjective nature of traditional morphology grading. This may ultimately lead to less precise disposition decisions and discarding of viable embryos. The application of a deep neural network, as shown in our study, can introduce improved reliability and high consistency during the process of embryo selection and disposition, potentially improving outcomes in an embryology laboratory.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Bormann CL,Thirumalaraju P,Kanakasabapathy MK,Kandula H,Souter I,Dimitriadis I,Gupta R,Pooniwala R,Shafiee H

doi

10.1016/j.fertnstert.2019.12.004

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

781-787.e1

issue

4

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(19)32605-6

journal_volume

113

pub_type

杂志文章
  • Acid Tyrode's solution can stimulate parthenogenetic activation of human and mouse oocytes.

    abstract::Fresh and aged (24 hours after ovulation) human oocytes and recently ovulated mouse oocytes may be activated by exposure to acidified Tyrode's solution. No activation of either type of human oocyte was observed after exposure to hyaluronidase or pronase, but significant numbers of fresh mouse oocytes were activated af...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/s0015-0282(16)53279-8

    authors: Johnson MH,Pickering SJ,Braude PR,Vincent C,Cant A,Currie J

    更新日期:1990-02-01 00:00:00

  • Polycystic ovary syndrome is associated with negatively variable impacts on domains of health-related quality of life: evidence from a meta-analysis.

    abstract:OBJECTIVE:To systematically review the literature to identify the impact of polycystic ovary syndrome (PCOS) on specific health-related quality of life domains. DESIGN:Meta-analysis. SETTING:N/A. PATIENT(S):The outcomes of 423 patients and 285 controls from 5 articles that used the Short Form 36 (SF-36) questionnair...

    journal_title:Fertility and sterility

    pub_type: 杂志文章,meta分析,评审

    doi:10.1016/j.fertnstert.2011.05.072

    authors: Li Y,Li Y,Yu Ng EH,Stener-Victorin E,Hou L,Wu T,Han F,Wu X

    更新日期:2011-08-01 00:00:00

  • Ovarian response in three consecutive in vitro fertilization cycles.

    abstract:OBJECTIVE:This study was designed to assess the ovarian response in the same patient in consecutive IVF cycles. DESIGN:Retrospective study. SETTING:Assisted reproductive unit at a university hospital. PATIENT(S):One hundred ninety women who underwent three consecutive cycles of IVF. INTERVENTION(S):All women used a...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/s0015-0282(01)03237-x

    authors: Hoveyda F,Engmann L,Steele J,Lopez Bernal A,Barlow DH

    更新日期:2002-04-01 00:00:00

  • Pregnancy outcomes decline with increasing body mass index: analysis of 239,127 fresh autologous in vitro fertilization cycles from the 2008-2010 Society for Assisted Reproductive Technology registry.

    abstract:OBJECTIVE:To examine the effect of body mass index (BMI) on IVF outcomes in fresh autologous cycles. DESIGN:Retrospective cohort study. SETTING:Not applicable. PATIENT(S):A total of 239,127 fresh IVF cycles from the 2008-2010 Society for Assisted Reproductive Technology registry were stratified into cohorts based on...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/j.fertnstert.2015.11.008

    authors: Provost MP,Acharya KS,Acharya CR,Yeh JS,Steward RG,Eaton JL,Goldfarb JM,Muasher SJ

    更新日期:2016-03-01 00:00:00

  • Quantification of nucleolar channel systems: uniform presence throughout the upper endometrial cavity.

    abstract:OBJECTIVE:To determine the prevalence of nucleolar channel systems (NCSs) by uterine region, applying continuous quantification. DESIGN:Prospective clinical study. SETTING:Tertiary care academic medical center. PATIENT(S):Forty-two naturally cycling women who underwent hysterectomy for benign indications. INTERVENT...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/j.fertnstert.2012.10.027

    authors: Szmyga MJ,Rybak EA,Nejat EJ,Banks EH,Whitney KD,Polotsky AJ,Heller DS,Meier UT

    更新日期:2013-02-01 00:00:00

  • Female exposure to phenols and phthalates and time to pregnancy: the Maternal-Infant Research on Environmental Chemicals (MIREC) Study.

    abstract:OBJECTIVE:To assess the potential effect of bisphenol A (BPA), triclosan (TCS), and phthalates on women's fecundity, as measured by time to pregnancy (TTP). DESIGN:Pregnancy-based retrospective TTP study. SETTING:Not applicable. PATIENT(S):A total of 2,001 women during the first trimester of pregnancy recruited betw...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/j.fertnstert.2015.01.005

    authors: Vélez MP,Arbuckle TE,Fraser WD

    更新日期:2015-04-01 00:00:00

  • Superovulation with intrauterine insemination in the treatment of infertility: a possible alternative to gamete intrafallopian transfer and in vitro fertilization.

    abstract::In vitro fertilization and embryo transfer (IVF-ET) and gamete intrafallopian transfer (GIFT) are used to treat intractable infertility in women with no distortion of the pelvic viscera, despite the lack of controlled trials demonstrating efficacy. The mechanism of any purportedly enhanced cycle fecundity in ovulatory...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/s0015-0282(16)59414-x

    authors: Dodson WC,Whitesides DB,Hughes CL Jr,Easley HA 3rd,Haney AF

    更新日期:1987-09-01 00:00:00

  • Progesterone level and progesterone/estradiol ratio on the day of hCG administration: detrimental cutoff levels and new treatment strategy.

    abstract:OBJECTIVE:To identify if there are certain cutoff levels for P and or the P/E(2) ratio on the day of hCG that would be defined as detrimental for occurrence of pregnancy in women with normal ovarian reserve undergoing cleavage-stage embryo transfer (ET). Secondarily, to determine if these same cutoffs might have the sa...

    journal_title:Fertility and sterility

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.fertnstert.2010.12.065

    authors: Elgindy EA

    更新日期:2011-04-01 00:00:00

  • Effects of lower doses of conjugated equine estrogens and medroxyprogesterone acetate on endometrial bleeding.

    abstract:OBJECTIVE:To evaluate vaginal bleeding profiles with lower doses of conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA) as continuous combined therapy. DESIGN:The Women's Health, Osteoporosis, Progestin, Estrogen (Women's HOPE) study, a randomized, double-blind, placebo-controlled trial. SETTING:S...

    journal_title:Fertility and sterility

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1016/s0015-0282(01)01792-7

    authors: Archer DF,Dorin M,Lewis V,Schneider DL,Pickar JH

    更新日期:2001-06-01 00:00:00

  • Sonographic assessment of endometrial pattern and thickness in patients treated with human menopausal gonadotropins.

    abstract:OBJECTIVE:To analyze sonographically the endometrium in patients undergoing controlled ovarian stimulation with menotropins in order to determine the significance of endometrial pattern and thickness on pregnancy rate. DESIGN:This is a prospective, nonrandomized study comparing pregnancy rates in patients with hyperec...

    journal_title:Fertility and sterility

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0015-0282(16)58447-7

    authors: Bohrer MK,Hock DL,Rhoads GG,Kemmann E

    更新日期:1996-08-01 00:00:00

  • Lack of effect of short-term diazoxide administration on luteinizing hormone secretion in women with polycystic ovary syndrome.

    abstract:OBJECTIVE:To test the hypothesis that an acute reduction in circulating insulin affects LH secretion in women with polycystic ovary syndrome (PCOS). DESIGN:Prospective study in normal and PCOS women. SETTING:General Clinical Research Centers at the University of Virginia, the Medical College of Virginia, and the Mass...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/j.fertnstert.2006.11.109

    authors: Evans WS,Taylor AE,Boyd DG,Johnson ML,Matt DW,Jimenez Y,Nestler JE

    更新日期:2007-07-01 00:00:00

  • Assisted reproductive technologies (ART) in Canada: 2004 results from the Canadian ART Register.

    abstract:OBJECTIVE:To present the results of assisted reproductive technology (ART) cycles performed in 2004 in Canada. This is the fourth annual report of Canadian ART outcomes. DESIGN:Prospective cohort study. SETTING:Twenty-six of 26 ART centers in Canada. PATIENT(S):Couples undergoing ART treatment in Canada during 2004....

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/j.fertnstert.2007.05.015

    authors: Gunby J,Bissonnette F,Librach C,Cowan L,IVF Directors Group of the Canadian Fertility and Andrology Society.

    更新日期:2008-05-01 00:00:00

  • Carbohydrate and lipid studies in women using the progesterone intrauterine device for one year.

    abstract::Carbohydrate and lipid metabolism was evaluated in 31 women before and after 1 year's use of a progesterone-releasing intrauterine device. The studies involved measuring blood glucose and plasma insulin levels during a 3-hour oral glucose tolerance test and also measuring fasting cholesterol and triglyceride levels. T...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/s0015-0282(16)43932-4

    authors: Spellacy WN,Buhi WC,Birk SA

    更新日期:1979-04-01 00:00:00

  • Reproductive sequelae of parental severe illness before the pandemic: implications for the COVID-19 pandemic.

    abstract:OBJECTIVE:To investigate, with pre-COVID-19 data, whether parental exposure to severe systemic infections near the time of conception is associated with pregnancy outcomes. DESIGN:Retrospective cohort study. SETTING:Population-based study covering births within the United States from 2009 to 2016. PARTICIPANTS:The I...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/j.fertnstert.2020.09.153

    authors: Kasman AM,Bhambhvani HP,Li S,Zhang CA,Stevenson DK,Shaw GM,Simard JF,Eisenberg ML

    更新日期:2020-12-01 00:00:00

  • Adhesion formation from release of dermoid contents in the peritoneal cavity and effect of copious lavage: a prospective, randomized, blinded, controlled study in a rabbit model.

    abstract:OBJECTIVES:To determine, in a rabbit model, whether peritoneal exposure to dermoid cyst material produces inflammation and adhesions above control levels and whether saline lavage reduces the degree of peritoneal reaction. DESIGN:A prospective, randomized, blinded, controlled study of adhesion formation. Thirty New Ze...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/s0015-0282(16)58225-9

    authors: Fielder EP,Guzick DS,Guido R,Kanbour-Shakir A,Krasnow JS

    更新日期:1996-04-01 00:00:00

  • Calcium-dependent up-regulation of mitochondrial electron transfer chain gene expressions in human luteinized granulosa cells.

    abstract:OBJECTIVE:To evaluate the transcription and translation ability of mitochondria in terminally differentiated granulosa cells, these cells were incubated with ionic calcium. DESIGN:Prospective laboratory research. SETTING:In vitro fertilization laboratory in a university hospital. PATIENT(S):Granulosa cells were harv...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/j.fertnstert.2005.03.072

    authors: Au HK,Yeh TS,Kao SH,Shih CM,Hsieh RH,Tzeng CR

    更新日期:2005-10-01 00:00:00

  • Techniques for removal of the Essure hysteroscopic tubal occlusion device.

    abstract:OBJECTIVE:To present two case reports of techniques for removal of the Essure (Conceptus, Inc., Mountain View, CA) hysteroscopic tubal occlusion device. DESIGN:Case report. SETTING:University-affiliated teaching hospital. PATIENT(S):Two women requesting removal of Essure devices because of persistent pelvic pain up ...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/j.fertnstert.2006.11.072

    authors: Lannon BM,Lee SY

    更新日期:2007-08-01 00:00:00

  • Correlation of human in vitro fertilization with the hamster egg bioassay.

    abstract::We compared fertility potential measurements by the zona-free hamster egg bioassay with the in vitro fertilization of human eggs. Sperm from 24 husbands participating in an in vitro fertilization-embryo transfer program were used in 27 inseminations of the wives' eggs and in simultaneous inseminations of hamster eggs....

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/s0015-0282(16)47177-3

    authors: Wolf DP,Sokoloski JE,Quigley MM

    更新日期:1983-07-01 00:00:00

  • The relationship between coping and depression in men and women referred for in vitro fertilization.

    abstract::This study examined coping with infertility and how coping is related to depression for men and women. Results showed that both men and women who engage in a disproportionate degree of escape/avoidance behavior and acceptance of responsibility for infertility were more vulnerable to symptoms of depression. ...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/j.fertnstert.2005.09.020

    authors: Peterson BD,Newton CR,Rosen KH,Skaggs GE

    更新日期:2006-03-01 00:00:00

  • Pathogenesis, consequences, and control of peritoneal adhesions in gynecologic surgery.

    abstract::Postoperative adhesions are a natural consequence of surgical tissue trauma and healing and may result in infertility, pain, and bowel obstruction. Adherence to microsurgical principles, minimally invasive surgery, and use of some peritoneal instillates may help to decrease postoperative adhesions. Some surgical barri...

    journal_title:Fertility and sterility

    pub_type: 杂志文章,评审

    doi:10.1016/j.fertnstert.2007.04.066

    authors: Practice Committee of the American Society for Reproductive Medicine.,Society of Reproductive Surgeons.

    更新日期:2007-07-01 00:00:00

  • Reproductive surgery for müllerian anomalies: a review of progress in the last decade.

    abstract::Disorders of development, fusion, or resorption of paired müllerian ducts and urogenital sinus may cause various congenital malformations of the corpus uteri, cervix, vagina, and fallopian tubes. Classification systems have been developed to better characterize these anomalies, and each has advantages and disadvantage...

    journal_title:Fertility and sterility

    pub_type: 杂志文章,评审

    doi:10.1016/j.fertnstert.2019.07.005

    authors: Ludwin A,Pfeifer SM

    更新日期:2019-09-01 00:00:00

  • Luteal phase support.

    abstract:OBJECTIVE:To develop a consensus regarding the need for luteal phase support during assisted reproductive technology (ART), and to establish the optimal compound and route of administration for this purpose. DESIGN:Review of the published literature on luteal phase support. PATIENT(S):Women undergoing assisted reprod...

    journal_title:Fertility and sterility

    pub_type: 杂志文章,评审

    doi:10.1016/s0015-0282(01)02961-2

    authors: Penzias AS

    更新日期:2002-02-01 00:00:00

  • Preovulatory human follicular fluid in vitro inhibits interleukin (IL)-1 alpha, IL-2, and production and expression of p55 chain IL-2 receptor of lymphomonocytes.

    abstract:OBJECTIVE:To evaluate the immunoactivity of human follicular fluids (FFs) of ovaries stimulated with exogenous gonadotropins. PARTICIPANTS:Follicular fluids and peripheral blood mononuclear cells (PBMCs) were obtained at the time of ovum pick-up from 15 women (25 to 34 years of age) undergoing gonadotropin stimulation...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/s0015-0282(16)56886-1

    authors: Macciò A,Mantovani G,Turnu E,Artini P,Contu G,Volpe A

    更新日期:1994-08-01 00:00:00

  • Report on varicocele and infertility: a committee opinion.

    abstract::This document discusses the evaluation and management of varicoceles in the male partners of infertile couples, and presents the controversies and recommendations regarding this condition. This document replaces the ASRM Practice Committee document titled "Report on Varicocele and Infertility," last published in 2008,...

    journal_title:Fertility and sterility

    pub_type: 杂志文章,实务指引

    doi:10.1016/j.fertnstert.2014.10.007

    authors: Practice Committee of the American Society for Reproductive Medicine.,Society for Male Reproduction and Urology.

    更新日期:2014-12-01 00:00:00

  • What serial hCG can tell you, and cannot tell you, about an early pregnancy.

    abstract::The serial measurement of serum hCG concentrations is an important clinical tool used to differentiate normal from abnormal pregnancies. At hCG values below which ultrasonography can be diagnostic, the comparison of a patient's hCG dynamics to those of established expected curves of rise or fall can aid the clinician ...

    journal_title:Fertility and sterility

    pub_type: 杂志文章,评审

    doi:10.1016/j.fertnstert.2012.09.014

    authors: Seeber BE

    更新日期:2012-11-01 00:00:00

  • Partial androgen insensitivity--are all tissues equal?

    abstract::Nonaromatizable androgens, administered in high doses to an adult patient with partial androgen insensitivity, failed to result in a change in phallic size despite a clear decline in SHBG and gonadotropin levels. These findings raise the question of differential tissue sensitivity to androgens. Because ancillary labor...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/s0015-0282(16)56114-7

    authors: Keely EJ,Belsham DD,Wrogemann K,Faiman C

    更新日期:1993-08-01 00:00:00

  • Members of the Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway are present and active in human sperm.

    abstract:OBJECTIVE:To investigate whether components of the Janus kinase/signal transducers and activators of transcription (JAK/STAT) pathway are present and active in human sperm. DESIGN:Comparative study. SETTING:Reproductive biology department. PATIENT(S):Nine sperm donors. INTERVENTION(S):Sperm were exposed to interfer...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/s0015-0282(01)01896-9

    authors: D'Cruz OJ,Vassilev AO,Uckun FM

    更新日期:2001-08-01 00:00:00

  • Determination of total menstrual blood loss.

    abstract:OBJECTIVE:To develop and validate a simple method of measuring total menstrual blood loss using a pictorial representation of blood loss, the menstrual pictogram. DESIGN:A prospective evaluation of total menstrual blood loss measurement by the menstrual pictogram compared to the alkaline hematin technique. SETTING:Ac...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/s0015-0282(01)01847-7

    authors: Wyatt KM,Dimmock PW,Walker TJ,O'Brien PM

    更新日期:2001-07-01 00:00:00

  • CYP1A1, CYP19, and GSTM1 polymorphisms increase the risk of endometriosis.

    abstract:OBJECTIVE:To investigate the possibility of genetic contribution of CYP1A1, CYP19, GSTM1, and GSTT1 polymorphisms to endometriosis. DESIGN:Genetic polymorphism analysis. SETTING:Case-control study. PATIENT(S):A group of 275 women with sporadic endometriosis was compared with a group of 346 fertile, endometriosis-fre...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/s0015-0282(02)04817-3

    authors: Arvanitis DA,Koumantakis GE,Goumenou AG,Matalliotakis IM,Koumantakis EE,Spandidos DA

    更新日期:2003-03-01 00:00:00

  • Secondary hypogonadism in hemochromatosis.

    abstract::Hemochromatosis is a rare disorder of iron storage. This report illustrates a case of hypogonadotropic-hypogonadism in a female with biopsy-proven hemochromatosis. Dynamic pituitary and gonadal testing revealed subnormal gonadotropin responses to gonadotropin-releasing hormone (GnRH) but normal ovarian reserve, as sho...

    journal_title:Fertility and sterility

    pub_type: 杂志文章

    doi:10.1016/s0015-0282(16)53842-4

    authors: Meyer WR,Hutchinson-Williams KA,Jones EE,DeCherney AH

    更新日期:1990-10-01 00:00:00