An Artificial Intelligence-Based Model to Predict Pregnancy After Intrauterine Insemination: A Retrospective Analysis of 9501 Cycles

<b>Background/Objectives:</b> Intrauterine insemination (IUI) is a common first-line approach in the treatment of numerous infertile couples, especially in cases of unexplained infertility. Its relatively low success rate, however, could benefit from the development of AI-based support tools to predict its outcome, thus helping the clinical management of patients undergoing IUI cycles. Our objective was to develop a robust and accurate machine learning model that predicts pregnancy outcomes following IUI. <b>Methods:</b> A retrospective, observational, and single-center study was conducted. In total, 3535 couples (aged 18-43 years) that underwent IUI between January 2011 and December 2015 were recruited. Twenty-one clinical and laboratory parameters of 9501 IUI cycles were used to train different machine learning algorithms. Accuracy of pregnancy outcome was evaluated by an area under the curve (AUC) analysis. <b>Results:</b> The linear SVM outperformed AdaBoost, Kernel SVM, Random Forest, Extreme Forest, Bagging, and Voting classifiers. Pre-wash sperm concentration, the ovarian stimulation protocol, cycle length, and maternal age were strong predictors of a positive pregnancy test following IUI (AUC = 0.78). Paternal age was found to be the worst predictor. <b>Conclusions:</b> Our Linear SVM model predicts a positive pregnancy outcome following IUI. Although this model shows value for the clinical management of infertile patients and informed decision-making by the patients, further validation using independent datasets is required prior to clinical implementation.