Embryo selection using time-lapse analysis (Early Embryo Viability Assessment) in conjunction with standard morphology: a prospective two-center pilot study

Kieslinger, D.C.; Gheselle, Stefanie De; Lambalk, Cornelis B.; Sutter, Petra De; Kostelijk, E.H.; Twisk, Jos W. R.; Rijswijk, Joukje van; Abbeel, E. Van den; Vergouw, C.G.

doi:10.1093/humrep/dew207

Cited by 46 publications

(33 citation statements)

References 17 publications

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“…Based on the results of this review, no negative effect of EmbryoScope compared with conventional incubator is confirmed. Safety of Primo Vision and Eeva have been confirmed by some observational studies published in recent years[31–33, 43]. As to the efficiency, economical burden and embryo assessment time comparison among different types of TLI systems, scarce evidence is now available.…”

Section: Discussionmentioning

confidence: 98%

Does time-lapse imaging have favorable results for embryo incubation and selection compared with conventional methods in clinical in vitro fertilization? A meta-analysis and systematic review of randomized controlled trials

Chen

Wei

et al. 2017

PLoS ONE

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ObjectiveThe present study aimed to undertake a review of available evidence assessing whether time-lapse imaging (TLI) has favorable outcomes for embryo incubation and selection compared with conventional methods in clinical in vitro fertilization (IVF).MethodsUsing PubMed, EMBASE, Cochrane library and ClinicalTrial.gov up to February 2017 to search for randomized controlled trials (RCTs) comparing TLI versus conventional methods. Both studies randomized women and oocytes were included. For studies randomized women, the primary outcomes were live birth and ongoing pregnancy, the secondary outcomes were clinical pregnancy and miscarriage; for studies randomized oocytes, the primary outcome was blastocyst rate, the secondary outcome was good quality embryo on Day 2/3. Subgroup analysis was conducted based on different incubation and embryo selection between groups.ResultsTen RCTs were included, four randomized oocytes and six randomized women. For oocyte-based review, the pool-analysis observed no significant difference between TLI group and control group for blastocyst rate [relative risk (RR) 1.08, 95% CI 0.94–1.25, I2 = 0%, two studies, including 1154 embryos]. The quality of evidence was moderate for all outcomes in oocyte-based review. For woman-based review, only one study provided live birth rate (RR 1,23, 95% CI 1.06–1.44,I2 N/A, one study, including 842 women), the pooled result showed no significant difference in ongoing pregnancy rate (RR 1.04, 95% CI 0.80–1.36, I2 = 59%, four studies, including 1403 women) between two groups. The quality of the evidence was low or very low for all outcomes in woman-based review.ConclusionsCurrently there is insufficient evidence to support that TLI is superior to conventional methods for human embryo incubation and selection. In consideration of the limitations and flaws of included studies, more well designed RCTs are still in need to comprehensively evaluate the effectiveness of clinical TLI use.

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Section: Discussionmentioning

confidence: 98%

Does time-lapse imaging have favorable results for embryo incubation and selection compared with conventional methods in clinical in vitro fertilization? A meta-analysis and systematic review of randomized controlled trials

Chen

Wei

et al. 2017

PLoS ONE

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“…The use of Eeva® in addition with standard morphology assessment has been compared with standard morphology assessment in few randomized clinical trials with different conclusions. On one hand Eeva® seemed to give objective information for helping embryologists with various levels of experience to choose the best embryo to transfer in a double-blinded multi-center study with 54 patients undergoing blastocyst transfer (Diamond et al, 2015), on the other hand, an observational prospective two-center study did not demonstrate any improvement in cycle outcome when using Eeva® (Kieslinger et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…Automated annotation of embryo morphokinetic parameters could theoretically tackle these 2 issues, leading to improved workflow, high throughput analysis, and lower subjectivity. However, a commercially available automated TLM system based on few early parameters recently failed in confirming its clinical relevance in a prospective trial (Kieslinger et al, 2016), highlighting the need for a robust and multiparametric automated annotation tool. To our knowledge, only one pilot study reported the set-up of a semi-automated script annotating embryo morphokinetic parameters in humans (Mölder et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Development of a robust automated tool for the annotation of embryo morphokinetic parameters

Feyeux

Reignier

Mocaer

et al. 2018

Preprint

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Study question:Is it possible to automatically annotate human embryo development in time-lapse devices, with results comparable to manual annotation? Summary answer: We developed an automated tool for the annotation of embryo morphokinetic parameters having a high concordance with expert manual annotation in a large scale-study.What is known already: Morphokinetic parameters obtained with time-lapse devices are increasingly used for human embryo quality assessment. However, their annotation is timeconsuming and can be operator-dependent, highlighting the need of developing automated approaches. Study design, size, duration:This monocentric pilot study was conducted using 701 blastocysts originating from 584 couples undergoing IVF with embryo culture in a time-lapse device and on 4 mouse embryos.Participants/materials, setting, methods: An automated annotation tool was developed based on grey level coefficient of variation and detection of the thickness of the zona pellucida. The timings of cellular events obtained with the automated tool were compared with those obtained manually by 2 expert embryologists. The same procedure was applied on 4 mouse preimplantation embryos obtained with a different device in a different setting.Main results and the role of chance: Although some differences were found when embryos were considered individually, we found an overall excellent concordance between automated and manual annotation of human embryo morphokinetics from fertilization to expanded blastocyst stage (r²=0.94). Moreover, the automated annotation tool gave promising results across species (human, mice). Limitations, reasons for caution:These results should undergo multi-centric external evaluation in order to test the overall performance of the annotation tool.Wider implications of the findings: Our system performs significantly better than the ones reported in the literature and on a bigger cohort, paving the way for high-throughput analysis of multicentric morphokinetic databases, providing new insights into the clinical value of morphokinetics as predictor of embryo quality and implantation.

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“…For instance, employment of conical dishes is required during culture employing a commercially available time-lapse system called EmbryoScope™, which may create a unique beneficial surrounding for the embryo in a lowdensity single-embryo culture. Hitherto, validation of the superiority of these technologies regarding culture conditions is pending (78).…”

Section: Latest Trendsmentioning

confidence: 99%

Considerations Regarding Embryo Culture Conditions: From Media to Epigenetics

Simopoulou

Sfakianoudis²,

Rapani

et al. 2018

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Embryo selection using time-lapse analysis (Early Embryo Viability Assessment) in conjunction with standard morphology: a prospective two-center pilot study

Abstract: ClinicalTrials.gov: NCT01671644.

Cited by 46 publications

References 17 publications

Does time-lapse imaging have favorable results for embryo incubation and selection compared with conventional methods in clinical in vitro fertilization? A meta-analysis and systematic review of randomized controlled trials

Does time-lapse imaging have favorable results for embryo incubation and selection compared with conventional methods in clinical in vitro fertilization? A meta-analysis and systematic review of randomized controlled trials

Development of a robust automated tool for the annotation of embryo morphokinetic parameters

Considerations Regarding Embryo Culture Conditions: From Media to Epigenetics

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