Assessment of human embryos by time-lapse videography: A comparison of quantitative and qualitative measures between two independent laboratories

Between-laboratory reproducibility of time-lapse embryo selection using qualitative and quantitative parameters: a systematic review and meta-analysis

“…Binary outcomes of qualitative parameters are independent of absolute cleavage timings of embryos. In contrast to qualitative parameters, a study in two unrelated clinics found that even implanting embryos grew at very different rates, with the difference in time to reach the 8-cell stage (relative to pronuclear fading) being greater than 3 h [37]. This may imply the ability of in vitro cultured human embryos to adapt in response to different culture conditions without losing their implantation potential.…”

“…In 2011, Meseguer et al [1] published the first clinical algorithm for improved embryo selection via the use of TL incubation, which opened a new era in embryo selection as one of the critical parts of IVF treatment. With additional models being subsequently reported by different researchers, external validation of the Meseguer model was inconclusive, with both negative [6,8,37] and positive reports [20]. More recently, published work also revealed poor transferability when several models were applied on the same external dataset, including a commercially available model which had been claimed in the original report to be universally applicable [7].…”

“…The current study confirms this lack of universality as it clearly demonstrates the reduction in predictive power (AUC from 0.720 to 0.510) after pooling data from different studies. Indeed, the transferability issue was mainly due to different morphokinetic profiles of embryos (i.e., quantitative parameters) between laboratories [6][7][8]37], where the culture conditions employed (such as type of culture media or oxygen concentration in the incubation gas phase) could significantly alter embryo's developmental speed ( [9,38]). Therefore, clinics within the same institution are more likely to achieve consistent results [20].…”

Time-lapse imaging of cleavage divisions in embryo quality assessment

“…However, subsequent external retrospective studies did not confirm its high predictive power and even questioned whether any predictive algorithm can be used universally in IVF units (Freour et al 2015, Liu et al 2015c. Interestingly, a simplified version of Meseguer and coworkers's algorithm, utilizing only t5 and s2 parameters, has been positively validated by Freour et al (2015).…”

“…We have taken the first step: we have created algorithms that allow for effective embryo assessment in individual laboratories. Many of them fit the original set of data very well (AUC > 0.7), but they are often not transferable to other embryo cohorts and fail the independent validation (see discussion between Meseguer et al (2011) and Freour et al (2015) and Liu et al (2015c) or Campbell et al (2013aCampbell et al ( , 2013bCampbell et al ( , 2014, Basile et al (2014), Chawla et al (2015 and Rienzi et al (2015)). Therefore we need to make another step forward and focus our efforts on creation of an algorithm that would be effective in different clinics and that would take into consideration differences in IVF procedures (hormonal stimulation procedures, fertilization methods, culture media, etc.).…”