Correlation of fetal heartbeat outcome after Day 3 or Day 5 single embryo transfer of morphologically selected embryos with an annotation-free deep learning scoring system: Results from a multi-center study

J Assist Reprod Genet. 2025 Aug 12. doi: 10.1007/s10815-025-03570-x. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate whether the use of a fully automated AI-based scoring system (iDAScore V2) for selecting viable embryos using fetal heartbeat (FHB) as an indicator is equivalent to morphology assessment.

METHODS: A retrospective observational cohort study across four fertility centers analyzed embryos selected for single embryo transfer on Day 3 or Day 5 + based on morphology and time-lapse video. All transferred embryos from participating centers were retrospectively scored using a fully automated AI-based embryo scoring algorithm and standardized morphology assessment. The predictive ability of both methods for implantation (FHB rate) was compared for Day 3 and Day 5 + transfer.

RESULTS: A multi-center analysis revealed that AI-based embryo scoring significantly outperformed morphological embryo assessment in predicting FHB for both Day 3 (n = 2965) and Day 5 + (n = 6970) transfers (P

CONCLUSIONS: As a multi-center validation of fully automated embryo assessment, this study confirms that AI-based selection provides outcomes that are either equivalent to or superior to morphological embryo assessment, without compromising clinical outcomes.

PMID:40794157 | DOI:10.1007/s10815-025-03570-x