Alife Health, Inc., Cambridge, Massachusetts.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco.
Fertil Steril. 2022 Jul;118(1):101-108. doi: 10.1016/j.fertnstert.2022.04.003. Epub 2022 May 16.
OBJECTIVE: To develop an interpretable machine learning model for optimizing the day of trigger in terms of mature oocytes (MII), fertilized oocytes (2PNs), and usable blastocysts. DESIGN: Retrospective study. SETTING: A group of three assisted reproductive technology centers in the United States. PATIENT(S): Patients undergoing autologous in vitro fertilization cycles from 2014 to 2020 (n = 30,278). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Average number of MII oocytes, 2PNs, and usable blastocysts. RESULT(S): A set of interpretable machine learning models were developed using linear regression with follicle counts and estradiol levels. When using the model to make day-by-day predictions of trigger or continuing stimulation, possible early and late triggers were identified in 48.7% and 13.8% of cycles, respectively. After propensity score matching, patients with early triggers had on average 2.3 fewer MII oocytes, 1.8 fewer 2PNs, and 1.0 fewer usable blastocysts compared with matched patients with on-time triggers, and patients with late triggers had on average 2.7 fewer MII oocytes, 2.0 fewer 2PNs, and 0.7 fewer usable blastocysts compared with matched patients with on-time triggers. CONCLUSION(S): This study demonstrates that it is possible to develop an interpretable machine learning model for optimizing the day of trigger. Using our model has the potential to improve outcomes for many in vitro fertilization patients.
目的:开发一种可解释的机器学习模型,以优化触发日,从而获得更多成熟卵子(MII)、受精卵(2PN)和可用胚胎。
设计:回顾性研究。
地点:美国的三家辅助生殖技术中心。
患者:2014 年至 2020 年接受自体体外受精周期的患者(n=30278)。
干预:无。
主要观察指标:平均 MII 卵子数、2PN 数和可用胚胎数。
结果:使用线性回归结合卵泡计数和雌二醇水平,开发了一组可解释的机器学习模型。使用该模型对触发日或继续刺激进行逐天预测时,分别在 48.7%和 13.8%的周期中确定了早期和晚期触发的可能性。经过倾向评分匹配后,与按时触发的匹配患者相比,早期触发的患者平均有 2.3 个 MII 卵子较少、1.8 个受精卵较少和 1.0 个可用胚胎较少,而晚期触发的患者平均有 2.7 个 MII 卵子较少、2.0 个受精卵较少和 0.7 个可用胚胎较少。
结论:本研究表明,开发一种可优化触发日的可解释机器学习模型是可行的。使用我们的模型有可能改善许多体外受精患者的结局。
F S Rep. 2025-4-25