Time lapse deselection model for human day 3 in vitro fertilization embryos: the combination of qualitative and quantitative measures of embryo growth

This study presents a deselection model for human in vitro fertilization embryos independent of the insemination method, the qualitative component being more accurate when coupled with a quantitative component.

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Authors

Yanhe Liu, M.Sc., Vincent Chapple, M.B., B.S., F.R.A.N.Z.C.O.G., Katie Feenan, M.Sc., Peter Roberts, Ph.D., Phillip Matson, Ph.D.

Volume 105, Issue 3, Pages 656-662

Abstract

Objective:

To present a time-lapse deselection model involving both qualitative and quantitative parameters for assessing embryos on day 3.

Design:

Retrospective cohort study and prospective validation.

Setting:

Private IVF center.

Patient(s):

A total of 270 embryos with known implantation data (KID) after day 3 transfer from 212 IVF/intracytoplasmic sperm injection (ICSI) cycles were retrospectively analyzed for building the proposed deselection model, followed by prospective validation using an additional 66 KID embryos.

Intervention(s):

None.

Main Outcome Measure(s):

Morphological score on day 3, embryo morphokinetic parameters, abnormal cleavage patterns, and known implantation results.

Result(s):

All included embryos were categorized either retrospectively or prospectively into 7 grades (A+, A, B, C, D, E, F). Qualitative deselection parameters included poor conventional day 3 morphology, abnormal cleavage patterns identified via time-lapse monitoring, and <8 cells at 68 hours postinsemination. Quantitative parameters included time from pronuclear fading (PNF) to 5-cell stage and duration of 3-cell stage. KID implantation rates of embryos graded from A+ to F were 52.9%, 36.1%, 25.0%, 13.8%, 15.6%, 3.1%, and 0 respectively (area under the curve [AUC] = 0.762; 95% confidence interval [CI], 0.701–0.824), and a similar pattern was seen in either IVF (AUC = 0.721; 95% CI, 0.622–0.821) or ICSI embryos (AUC = 0.790; 95% CI, 0.711–0.868). Preliminary prospective validation using 66 KID embryos also showed statistically significant prediction in Medicult (AUC = 0.750; 95% CI, 0.588–0.912) and Vitrolife G-Series (AUC = 0.820; 95% CI, 0.671–0.969) suites of culture media. Conclusion(s):

The proposed model involving both qualitative and quantitative deselection effectively predicts day 3 embryo implantation potential and is applicable to all IVF embryos regardless of insemination method by using PNF as the reference starting time point.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)02078-6/fulltext

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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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