Skip to main content

Evolution of embryo selection for IVF from subjective morphology assessment to objective time-lapse algorithms improves chance of live birth

Fishel, Simon, Campbell, Alison, Foad, Fiona, Davies, Laina, Best, Louise, Davis, Natalie, Smith, Rachel, Duffy, Samantha, Wheat, Stacy, Montgomery, Sue, and others. (2020) Evolution of embryo selection for IVF from subjective morphology assessment to objective time-lapse algorithms improves chance of live birth. Reproductive BioMedicine Online, 40 (1). pp. 61-70. ISSN 1472-6483. (doi:10.1016/j.rbmo.2019.10.005) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:84038)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided. (Contact us about this Publication)
Official URL
https://doi.org/10.1016/j.rbmo.2019.10.005

Abstract

Research question: Does using an objective time-lapse imaging algorithm (TLIA) after IVF relate to conventional morphological assessment of human blastocysts as a prognosticator for live birth?

Design: Prospective use of a TLIA to select embryos in multicentre IVF clinics all using the same strictly controlled laboratory protocols. Each blastocyst was given a ranking from A to D, with the highest rank preferred for fresh transfer. This ranking was retrospectively compared with a given morphological score, which was blinded to the TLIA rank; all embryos were cultured under the same conditions. Results: Using multiple variable logistic regression models, TLIA embryo rank enabled greater discrimination between cycles with and without live births than the conventional morphology grade, even when considered in isolation, and when adjusting for covariates related to treatment and patient criteria. Of the 1810 cycles of single blastocyst transfer, 894 (49.4%) resulted in a live birth. A Vuong non-nested test including covariates showed strong evidence of the superiority of the embryo rank model compared with the transfer grade model (P = 0.0008 [raw], P = 0.0003 [Akaike information criterion – corrected]). From the receiver operating characteristic (ROC) curves across all possible thresholds the TLIA rank showed better true positive and true negative rates and had a higher area under the curve [AUC] of 67.43% compared with 61.74% for the blastocyst morphology grade. The same analysis but excluding covariates demonstrated an AUC of 62.86% versus 54.02%, respectively. Conclusion: Objective TLIA is superior for selecting embryos for their propensity to generate a live birth over a conventional, subjective blastocyst morphology scoring system.

Item Type: Article
DOI/Identification number: 10.1016/j.rbmo.2019.10.005
Subjects: Q Science
Divisions: Divisions > Division of Natural Sciences > School of Biosciences
Depositing User: Alison Campbell
Date Deposited: 10 Nov 2020 12:48 UTC
Last Modified: 10 Nov 2020 12:48 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/84038 (The current URI for this page, for reference purposes)
  • Depositors only (login required):