A novel machine-learning framework based on early embryo morphokinetics identifies a feature signature associated with blastocyst development.

BACKGROUND: Artificial Intelligence entails the application of computer algorithms to the huge and heterogeneous amount of morphodynamic data produced by Time-Lapse Technology. In this context, Machine Learning (ML) methods were developed in order to assist embryologists with automatized and objective predictive models able to standardize human embryo assessment. In this study, we aimed at developing a novel ML-based strategy to identify relevant patterns associated with the prediction of blastocyst development stage on day 5. METHODS: We retrospectively analysed the morphokinetics of 575 embryos obtained from 80 women who underwent IVF at our Unit. Embryo morphokinetics was registered using the Geri plus® time-lapse system. Overall, 30 clinical, morphological and morphokinetic variables related to women and embryos were recorded and combined. Some embryos reached the expanded blastocyst stage on day 5 (BL Group, n = 210), some others did not (nBL Group, n = 365). RESULTS: The novel EmbryoMLSelection framework was developed following four-steps: Feature Selection, Rules Extraction, Rules Selection and Rules Evaluation. Six rules composed by a combination of 8 variables were finally selected, and provided a predictive power described by an AUC of 0.84 and an accuracy of 81%. CONCLUSIONS: We provided herein a new feature-signature able to identify with an high performance embryos with the best developmental competence to reach the expanded blastocyst stage on day 5. Clear and clinically relevant cut-offs were identified for each considered variable, providing an objective tool for early embryo developmental assessment.

[The Hbf in Fanconi's anemia (author's transl)]. / L'emoglobina fetale nella anemia di Fanconi.

The Authors studied the HbF in an 8-year-old-girl with Fanconi's anemia. At the admission the patient was anemic (Hb 7,1 g%), thrombocytopenic and leucopenic, HbF was 23% (1,8 g%) with heterocellular distribution. Globin chain synthesis in the peripheral blood displayed an alpha/non alpha ratio of. 1,05. gamma-Chain analysis was performed: at position 136 the gamma G/gamma A ratio was 3:1 at positions 75 threonine was present in the 30% of the chains. The girl was transfused and oximetholone therapy was started. After 2 months of treatment, an increase of the Hb levels was observed. This improvement lasted about 5 months. The amount of HbF remained constant throughout the management. It may be suggested that androgens work only on HbA synthesis while the HbF-producing-cells are irresponsive to the hormonal stimulation.