In-vitro maturation of oocytes (IVM) is a new IVF technology developed in order to avoid iatrogenic complications of standard IVF treatments. This technique is particularly useful in patients suffering from polycystic ovary syndrome (PCOS) who are concerned with the risk of ovarian hyperstimulation syndrome. This technique is nowadays routinely practised in many international centres. However, the efficiency of this technique needs to be improved for a better support of maturation conditions to maximize oocyte developmental competence. In order to improve IVM results, the efficiency of two IVM media was retrospectively compared. Ninety-three PCOS candidates undergoing their first IVM cycle were included in this study, and IVM was conducted with TCM-199 or IVM-Medicult medium. This is the first study comparing two maturation media. Both media resulted in the same results concerning total oocyte maturation, fertilization, early embryo development and pregnancy rates.

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The two different culture media employed in this study had a significant (p<0.01) impact both on the dynamics of post-fertilization development and embryo quality, as assessed by subjective morphological parameters. Media-A had a significantly higher proportion of embryos reaching the blastocyst stage at <110 hours and a higher proportion of top-quality blastocysts. The area under the receiver operating curve obtained from the ML models was 80.9% for Media-A and 80.5% for Media-B. The models were deployed as a web-based service running a Python script to extract the relevant morphokinetic and clinical parameters of embryos in real-time to provide the predicted probability of 110-hour blast formation.CONCLUSIONS: There were significant differences in the rate of embryo development and the proportion of top-graded blastocysts between the two culture media. The models developed to estimate the probability of reaching the blastocyst stage in <110 hours had a similar ROC-AUC but different structures to account for the different dynamics of development induced by the culture media.IMPACT STATEMENT: This work showcases the importance of continuously evaluating the characteristics of embryo development as the IVF laboratory evolves. Models implemented for embryo evaluation need to be adjusted accordingly. This study also suggests that embryo development is significantly impacted by laboratory-specific parameters; therefore, ML models should be tailored to the ART setting in which they will be utilized. Finally, deploying these models in platforms that allow for rapid and seamless updates to new versions increases the ability of these decision-support systems to adapt to the continuously evolving IVF laboratory.SUPPORT: Institutional

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