Evidence map›Paper›PMID 40645623›Full record

ArticleBMJ open2025

Blastocyst selection through an interpretable artificial intelligence method versus traditional morphology grading: study protocol for a randomised controlled trial.

Shanshan Wang, Lei Chen, Guanqiao Shan, Chen Sun, Hang Liu, Yu Sun, Haixiang Sun

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Shanshan WangCenter for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
Lei ChenCenter for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
Guanqiao ShanDepartment of Mechanical & Industrial Engineering, University of Toronto, Toronto, Ontario, Canada.
Chen SunDepartment of Mechanical & Industrial Engineering, University of Toronto, Toronto, Ontario, Canada.
Hang LiuDepartment of Mechanical & Industrial Engineering, University of Toronto, Toronto, Ontario, Canada drhang.liu@mail.utoronto.ca sun@mie.utoronto.ca stevensunz@163.com.ORCID http://orcid.org/0000-0001-7948-4236
Yu SunDepartment of Mechanical & Industrial Engineering, University of Toronto, Toronto, Ontario, Canada drhang.liu@mail.utoronto.ca sun@mie.utoronto.ca stevensunz@163.com.
Haixiang SunCenter for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China drhang.liu@mail.utoronto.ca sun@mie.utoronto.ca stevensunz@163.com.ORCID http://orcid.org/0000-0002-1215-1792

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe quality of the blastocyst (day 5/6 embryo) selected for transfer is critical for the success of in vitro fertilisation (IVF) treatment. Embryologists perform blastocyst evaluation by observing the morphology of each blastocyst. Human assessment is subjective and inconsistent in predicting which blastocyst can result in a successful pregnancy or birth. Several artificial intelligence (AI) methods have been proposed to predict IVF outcomes from blastocyst images. However, the reasoning processes of these AI methods are uninterpretable, causing epistemic and ethical concerns that prevent their implementation in clinical practice. To address this issue, the authors developed a novel interpretable AI method for blastocyst selection. The method is clinically applicable because it is transparent to embryologists and allows them to understand its reasoning processes. This randomised controlled trial (RCT) aims to test the effectiveness of this blastocyst selection method with the aim of improving IVF outcomes. METHODS AND ANALYSIS: In this single-centre, single-blind RCT, we will enrol 1100 women aged 20-35 years undergoing their first cycle of IVF, with or without intracytoplasmic sperm injection. The study will be conducted at Nanjing Drum Tower Hospital, a public class A tertiary hospital in China. On the fifth day of embryo culture, participants with two or more usable blastocysts will be randomised in a 1:1 ratio to either the conventional morphology group or the AI group. The primary outcome is ongoing pregnancy, defined as a viable intrauterine pregnancy of 12 weeks gestation or more. ETHICS AND DISSEMINATION: The research ethics committee of the Nanjing Drum Tower Hospital approved this study (approval number: 2023-259-02). All participants will provide written informed consent prior to enrolment. The findings will be presented at international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ChiCTR2300076851.

Indexed as

Artificial IntelligenceBlastocystEmbryo TransferFertilization in VitroAdultChinaEmbryo Culture TechniquesFemaleHumansPregnancyPregnancy RateRandomized Controlled Trials as TopicSingle-Blind MethodSperm Injections, IntracytoplasmicYoung AdultArtificial IntelligenceEmbryologyReproductive medicine

Identifiers

PMID40645623
PMCPMC12248200

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.