AI Embryo Selection: What It Could Mean for Your IVF Cycle
If you have more than one embryo available for transfer, deciding which embryo should go first is an important part of IVF. For decades, we have relied on skilled embryologists to evaluate how embryos develop and grade them according to their appearance and stage of development. Today, artificial intelligence is beginning to give fertility teams additional information to consider.
I recently spoke with Dr. Eduardo Hariton, an OB-GYN and reproductive endocrinologist at Reproductive Science Center of the Bay Area, about EmbryoPredict, an AI-assisted technology being used to evaluate embryo images.
What interested me about this technology is its practical application. We are already collecting images of embryos and gathering tremendous amounts of information during an IVF cycle. AI gives us another way to analyze some of that information and potentially distinguish between embryos that otherwise appear quite similar.
How Do We Choose an Embryo Today?
Embryologists evaluate embryos according to how they develop in the laboratory. By the time an embryo reaches the blastocyst stage, they are looking at characteristics such as its development, expansion, and the appearance of the cells that will eventually become the baby and placenta.
This grading provides valuable information, but there is a human element to it. Two experienced embryologists may not grade an embryo in exactly the same way, particularly when comparing embryos that are relatively close in quality.
This is where AI becomes interesting.
EmbryoPredict analyzes images of embryos and compares them with patterns learned from thousands of previous embryo images and their outcomes. It then generates a score associated with the embryo's potential for a successful outcome.
The embryologist and physician still have the benefit of everything they know about the patient and the embryos. Age, medical history, embryo development, genetic testing, embryo grade, and the laboratory's own experience all remain part of the decision. The AI score gives the team another piece of information to consider when deciding which embryo to transfer first.
Where AI May Be Most Helpful
If you have only one embryo available for transfer, ranking your embryos obviously isn't the issue. If you have several embryos that look similar, the decision becomes more interesting.
In the randomized controlled trial Dr. Hariton discussed, more than 400 patients were assigned to embryo selection using traditional methods or traditional methods with AI assistance. The study found an overall improvement of approximately 5 percent with AI-assisted selection, with greater improvement seen in some groups, including older patients and those who had not used preimplantation genetic testing.
Those distinctions caught my attention.
As we age, there can be greater variability in the reproductive potential of our embryos. If you have several embryos and have chosen not to genetically test them, there may also be less information available to help determine which embryo should be transferred first.
This is precisely the kind of situation where additional information could be useful.
What About PGT?
Preimplantation genetic testing and AI embryo assessment provide different kinds of information.
PGT-A evaluates cells biopsied from an embryo to assess chromosome number. This becomes increasingly relevant with maternal age because the percentage of embryos with chromosome abnormalities increases as we get older.
EmbryoPredict analyzes the embryo's image. It looks for visual patterns associated with outcomes in the data on which the system was trained.
If embryos have undergone genetic testing, that information remains important. AI may then provide another way to evaluate or rank embryos being considered for transfer. For someone who has decided against PGT, AI image analysis may provide information that was not previously available from visual grading alone.
Understanding this distinction is important because AI image analysis is not a substitute for genetic testing. They are looking at different things.
There Are Limits to What AI Can Tell Us
One of the most interesting parts of my conversation with Dr. Hariton involved what is sometimes called the "black box" of artificial intelligence.
AI can evaluate an enormous number of pixels within an embryo image and identify patterns that would be extremely difficult for the human eye to recognize. The system can then associate those patterns with previous outcomes. What it cannot necessarily do is explain exactly which visual feature caused an embryo to receive a particular score.
That makes good research and validation essential. A compelling algorithm is only as useful as the data behind it and the clinical studies showing that it performs well with actual patients.
It also means that I would never want an AI score considered in isolation. An experienced fertility team has information about you and your IVF cycle that goes well beyond an image.
More Information Can Help Us Ask Better Questions
One of the things I have always believed about fertility care is that patients deserve to understand the decisions being made about their bodies and their embryos.
If you are going through IVF, ask your clinic how your embryos are graded and how the team determines which embryo to transfer first. If you are considering PGT, understand what that testing can and cannot tell you. If your clinic is using AI-assisted embryo assessment, ask how the score is incorporated into the final decision.
This is especially worth discussing if you have several embryos available and are trying to decide which one to transfer first.
AI is going to become a larger part of medicine, including reproductive medicine. I am interested in its potential because fertility care already produces an extraordinary amount of information, from hormone levels and ultrasound findings to embryo development and genetic testing. Finding better ways to use that information could help us make more informed decisions.
At Health Youniversity, I have always believed that technology and expert care work best when the patient remains an active participant. Understanding your options gives you a stronger foundation for conversations with your fertility team and for the decisions you make along the way.
My full conversation with Dr. Eduardo Hariton explores EmbryoPredict, embryo selection, genetic testing, egg and embryo freezing, and how new technology is finding its place within IVF.
Listen to my full conversation with Nora DeBora on Health Youniversity:
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About Eduardo Hariton
Eduardo Hariton is an Ob/Gyn and infertility specialist. He received his medical training at Harvard, where he completed a combined MD / MBA at Harvard Medical School and Harvard Business School and his Ob/Gyn residency at the Brigham and Women's Hospital and Massachusetts General Hospital. He completed his fellowship in Reproductive Endocrinology and Infertility at the University of California, San Francisco and practices clinically at the Reproductive Science Center of the Bay Area. He is the SVP of Clinical Growth and Innovation at US Fertility and the Managing Director of the USF Innovation Fund. He is also an advisor to several early-stage companies in the fertility space. He combines his clinical and business backgrounds to treat patients and think creatively about how to improve the care they receive when seeking fertility services.
Learn more about Reproductive Science Center of the Bay Area here: https://rscbayarea.com/
Meet Dr. Eduardo Hariton here: https://rscbayarea.com/doctors/hariton/
Follow RSC on Instagram: https://www.instagram.com/rscbayarea/
Follow RSC on LinkedIn: https://www.linkedin.com/company/reproductive-science-center-of-the-san-francisco-bay-area/
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