Evidence map›Paper›PMID 41808171›Full record

ArticleBMC medicine2026

Enhanced predictive performance of artificial intelligence in individualized ovarian stimulation of in vitro fertilization: a retrospective cohort study.

Guiquan Wang, Minyue Tang, Liming Zhou, Fengcheng Li, Xiaoling Hu, Yunxian Yu, Haochao Ying, Ian Chew, Kai Zhu, Yimin Zhu

Abstract read
In one paragraph

Article in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Guiquan Wang *Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, No. 1 Xueshi Road, Hangzhou, Zhejiang Province, China. frank_sjtu@hotmail.com.ORCID 0000-0002-6434-1627
Minyue Tang *Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, No. 1 Xueshi Road, Hangzhou, Zhejiang Province, China.
Liming ZhouCenter for Reproductive Medicine, Ningbo Women & Children's Hospital, Ningbo, Zhejiang Province, China.
Fengcheng LiSchool of Pharmaceutical Sciences, Zhejiang University, Hangzhou, Zhejiang Province, China.
Xiaoling HuDepartment of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, No. 1 Xueshi Road, Hangzhou, Zhejiang Province, China.
Yunxian YuDepartment of Epidemiology and Health Statistics, School of Public Health, Zhejiang University, Hangzhou, Zhejiang Province, China.
Haochao YingDepartment of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, Zhejiang Province, China.
Ian ChewSchool of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
Kai ZhuDepartment of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, No. 1 Xueshi Road, Hangzhou, Zhejiang Province, China.
Yimin ZhuDepartment of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, No. 1 Xueshi Road, Hangzhou, Zhejiang Province, China. zhuyim@zju.edu.cn.ORCID 0000-0002-9667-3677

Funding

the Key research and development Program of Zhejiang Province 2025C02116the National Natural Science Foundation of China 81803245the National Natural Science Foundation of China 82071604the National Natural Science Foundation of China 82401908the Xiamen City Medical and Health Guidance Project 3502Z20244ZD1220
6 · The paper itself

Abstract

backgroundOver 2.5 million cycles in vitro fertilization (IVF) are conducted annually, and numbers are expected to rise with the aging population. The controlled ovarian stimulation (COS) process, key to IVF success, is inherently complex. Given advances in artificial intelligence (AI), this study investigated whether a series of AI models can outperform traditional clinical practices in predictive accuracy and COS optimization.

methodsThis retrospective cohort study analyzed first-cycle ovarian stimulation patients (Oct 2017-Dec 2020) and was validated using an independent cohort (Jan 2018-Jan 2022). Six AI algorithms and 73 variables were screened. A four-submodel strategy included risk prediction models for low and hyper ovarian response (LORRM, HORRM) and strategy deployment models (LORSM, HORSM) for managing critical COS components. Feature importance was assessed using Shapley additive explanations, with sensitivity analyses performed for robustness. The ability to propose effective COS strategies was also retrospectively assessed.

resultsA four-submodel system prototype using extreme gradient boosting trees was developed. All submodels showed superior discrimination compared to conventional ovarian reserve markers (AUC, 95% CI: LORSM, 0.95 [0.94-0.96]; LORRM, 0.93 [0.92-0.94]; HORSM, 0.90 [0.88-0.91]; HORRM, 0.89 [0.87-0.91]. DeLong P < 0.001 for all). They demonstrated adequate calibration (Brier scores of four submodels ranged from 0.064 to 0.072), promising performance in external validation (AUCs ranging from 0.84 to 0.88) and sensitivity analyses. Among COS components, COS protocol and recombinant follicle-stimulating hormone (FSH) use had the largest impact on low and hyper response risks, respectively, with FSH starting dose ranking third. Diastolic blood pressure, alanine aminotransferase, and white blood cell count predicted low response, while basal luteinizing hormone (LH) levels and platelet count were key for hyper response. Several were newly identified potential biomarkers. LORSM and HORSM identified effective strategies with precision of 95.5% (95% CI, 94.6-96.4%) and 98.4% (95% CI, 98.0-98.9%), respectively.

conclusionsThe AI-based system demonstrated superior detection of abnormal ovarian responses and effective individualized COS design compared to conventional clinical practice while maintaining transparency. The system identified potential biomarkers beyond conventional ovarian reserve markers and offered new insights for optimizing IVF, showing promise for advancing personalized reproductive medicine.

Indexed as

Artificial IntelligenceFertilization in VitroOvulation InductionAdultFemaleHumansPrediction AlgorithmsRetrospective StudiesArtificial intelligenceControlled ovarian stimulationHyper ovarian responseIn vitro fertilizationLow ovarian responseMachine learningPersonalized medicine

Identifiers

PMID41808171
PMCPMC13085636

What Socratic holds

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LicenceCC BY
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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 Socratic graph.