Abstract

Abstract Study question How effectively can a latent diffusion model generate high-fidelity embryo images tailored to the specific contextual needs of researchers, based on the user’s text input? Summary answer The latent diffusion model successfully generated high-resolution embryo images, providing a novel approach to address data scarcity in embryo imaging. What is known already The use of AI in generating synthetic data has been increasingly explored to address the scarcity of real-world datasets in various fields. Particularly in medical imaging, AI-generated synthetic data offers a potential solution to overcome the limitations imposed by data privacy concerns and ethical considerations. Previous studies have shown that AI can replicate complex patterns in data, but its application in generating embryo images remains less explored. Study design, size, duration Single static images of 5,133 Day 5 blastocysts and 2,093 Day 3 cleavages were retrospectively collected from seven in vitro fertilization clinics between June 2011 and May 2022. The images were analyzed along with relevant metadata including clinical information and embryo grades. Day 3 embryo grading was based on the number of blastomeres, evenness, and fragmentation percentage. Day 5 grading criteria included the inner cell mass, trophectoderm, and blastocyst stage evaluations. Participants/materials, setting, methods An AI model using latent diffusion was developed to generate 10,051 Day 5 and 10,088 Day 3 synthetic embryo images. The authenticity was assessed through visual Turing tests, where embryologists discerned real from synthetic images. For the evaluation, 200 real (100 Day 5, 100 Day 3) and 200 synthetic (100 Day 5, 100 Day 3) images were randomly chosen from each dataset, ensuring a comprehensive test of the generated images’ realism. Main results and the role of chance The AI model’s efficacy in generating synthetic embryo images was assessed through visual Turing tests on Day 5 and Day 3 embryos, yielding accuracies of 0.59 and 0.57, respectively. These accuracies fall within the 99% confidence interval of near-random performance (0.41 to 0.59), highlighting the challenge in distinguishing synthetic from real images. For Day 5 embryos, the sensitivity and specificity were recorded at 0.52 and 0.66, indicating a moderate challenge in identifying synthetic images and a relatively higher ease in recognizing real ones. Day 3 embryos presented a lower sensitivity of 0.41, suggesting greater difficulty in detecting synthetic images, while the specificity increased to 0.73, indicating a stronger ability to identify real images. Collectively, with an overall accuracy of 0.58, sensitivity of 0.47, and specificity of 0.70, these findings confirm the synthetic images’ remarkable realism, closely emulating actual embryo features to the extent that differentiation by experts proved challenging. This level of realism underscores the synthetic images’ potential to significantly enrich embryological research datasets, promising advancements in the field. Limitations, reasons for caution The study’s limitation lies in the generated synthetic embryos being based on three embryo grade categories, limiting feature diversity. Additionally, there was no quantitative assessment method for these images, relying instead on expert evaluation, which required deploying a large number of embryologists. Wider implications of the findings The model’s generation of highly realistic embryo images counters data scarcity in embryological research, potentially elevating AI’s utility, enriching educational content, advancing reproductive medicine, and ensuring ethical data usage. Trial registration number not applicable

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