Key metrics and processes for validating embryo diagnostics
A simple paradigm yields metrics allowing direct assessment of the validity of embryo diagnostics, including analytical stability, positive and negative predictive values, and randomized controlled trial data on clinical impact.
Volume 114, Issue 1, Pages 16–23
Chaim Jalasa, Emre Seli, M.D., Richard T. Scott Jr., M.D., H.C.L.D./A.L.D.
Embryo diagnostics are somewhat controversial in clinical assisted reproduction technology (ART) practice and remain an active area of investigation. Application of embryo diagnostics holds great potential to raise the standard of clinical care by eliminating futile transfers, allowing highly effective single-embryo transfer, and reducing the probability of clinical loss and ongoing abnormal gestations. These advantages are accompanied by risks, principally the chance that a reproductively competent embryo will be mislabeled and discarded. This would lower the ultimate probability that one or more of the embryos might implant and lead to delivery of a healthy infant. Rigorous validation should be required for embryo diagnostics. Metrics for validation can be divided into three simple areas: analytical validation, determination of clinical predictive values for normal and abnormal test results, and a randomized clinical trial to demonstrate that the selection advantage gained through the diagnostic improves clinical outcomes.