Machine learning center-specific models show improved IVF live birth predictions over US national registry-based model

Abstract Expanding in vitro fertilization (IVF) access requires improved patient counseling and affordability via cost-success transparency. Clinicians ask how two types of live birth prediction (LBP) models perform: machine learning, center-specific (MLCS) models and the multicenter, US national re...

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Main Authors: Mylene W. M. Yao, Elizabeth T. Nguyen, Matthew G. Retzloff, L. April Gago, John E. Nichols, John F. Payne, Barry A. Ripps, Michael Opsahl, Jeremy Groll, Ronald Beesley, Gregory Neal, Jaye Adams, Lorie Nowak, Trevor Swanson, Xiaocong Chen
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Nature Communications
Online Access:https://doi.org/10.1038/s41467-025-58744-z
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Summary:Abstract Expanding in vitro fertilization (IVF) access requires improved patient counseling and affordability via cost-success transparency. Clinicians ask how two types of live birth prediction (LBP) models perform: machine learning, center-specific (MLCS) models and the multicenter, US national registry-based model produced by Society for Assisted Reproductive Technology (SART). In a retrospective model validation study, we tested whether MLCS performs better than SART using 4635 patients’ first-IVF cycle data from 6 centers. MLCS significantly improved minimization of false positives and negatives overall (precision recall area-under-the-curve) and at the 50% LBP threshold (F1 score) compared to SART (p < 0.05). To contextualize, MLCS more appropriately assigned 23% and 11% of all patients to LBP ≥ 50% and LBP ≥ 75% whereas SART gave lower LBPs. Here, we show MLCS improves model metrics relevant for clinical utility – personalizing prognostic counseling and cost-success transparency – and is externally validated. We recommend evaluating MLCS in a larger sample of fertility centers.
ISSN:2041-1723