Morphokinetic analysis and embryonic prediction for blastocyst formation through an integrated time-lapse system

Motato, Y.; Santos, María José de los; Escribá, Marı́a José; Ruiz, B. Aparicio; Remohı́, José; Meseguer, Marcos

doi:10.1016/j.fertnstert.2015.11.001

Cited by 163 publications

(99 citation statements)

References 47 publications

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“…Second, our findings do not delineate whether the impairment in blastocyst development begins with the oocyte and with post-fertilization events, or if it specifically occurs between days 3 and 5 of embryo development. Time-lapse imaging of embryos may be potentially useful in identifying these time points [32] . Third, our results may be limited to FMR1 pre-mutation carriers with mid-size (80-120) CGG repeats.…”

Section: Discussionmentioning

confidence: 99%

Impact of FMR1 Pre-Mutation Status on Blastocyst Development in Patients Undergoing Pre-Implantation Genetic Diagnosis

Hutchinson

Pereira

Lilienthal

et al. 2017

Gynecol Obstet Invest

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Background/Aims: The study aimed to investigate the impact of fragile X mental retardation 1 (FMR1) pre-mutation status on blastocyst development in patients undergoing pre-implantation genetic diagnosis (PGD). Methods: Case-control study of patients <40 years undergoing PGD at blastocyst stage for FMR1 pre-mutation status. Age-matched patients undergoing PGD for other single gene disorders were considered controls. Blastocyst development, calculated per metaphase II (MII) oocyte retrieved and per 2 pronuclear (2PN) embryos, was compared between the 2 groups. Pregnancy outcomes after embryo transfer were also compared. Results: Eighty-one and 791 patients were included in the FMR1 and control groups, respectively. FMR1 pre-mutation carriers had lower indicators of ovarian reserve, required higher gonadotropin doses, and had fewer MII oocytes retrieved. Mean blastocyst development per MII oocyte (12.6 vs. 29.4%; p < 0.001) and per 2PN embryos (21.5 vs. 41.7%; p < 0.001) was lower in the FMR1 group. An inverse correlation between the number of FMR1 CGG repeats and blastocyst development per MII oocyte (ρ = -0.63; p < 0.001) was observed. There was no difference in the rates of clinical pregnancy, spontaneous abortion, or live birth among the groups. Conclusion: Our study suggests lower rates of blastocyst development in patients with FMR1 pre-mutation status and an inverse correlation between the number of FMR1 CGG repeats and blastocyst development.

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Section: Discussionmentioning

confidence: 99%

Impact of FMR1 Pre-Mutation Status on Blastocyst Development in Patients Undergoing Pre-Implantation Genetic Diagnosis

Hutchinson

Pereira

Lilienthal

et al. 2017

Gynecol Obstet Invest

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“…These parameters were less predictive for implantation potential. The parameters with the power of implantation prediction were time for expansion blastocyst (tEB) and t8-t5 [12].…”

Section: Arguments Supporting Predictive Value Of Tlsmentioning

confidence: 99%

Embryo Morphokinetics Based on Time-Lapse Observation

Tabibnejad¹

2017

Embryo Cleavage

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Embryo incubation and evaluation are critical steps in assisted reproductive technology (ART). Conventionally, embryo assessment has been done by embryologists through removing embryos from a conventional incubator during the culture period. Over recent years, time-lapse systems (TLS) have been established which can take digital images of embryos at key points and time intervals. This technique allows embryologists to assess the embryo quality in the steady culture environment. According to TLS studies and prepared algorithm models, it seems that TLS alone or in combination with conventional morphology can be considered as a useful diagnostic tool to determine high-quality embryos and improve embryonic implantation and pregnancy rates. In addition, there were remarkable diferences between embryo developmental time points and intervals regarding embryo gender, embryo fragmentation, and type of ovarian stimulation protocol. For conident conclusion, time-lapse imaging should be evaluated in further studies, and the system should be evaluated for cost/beneit ratio efectiveness in individual laboratory.Keywords: embryo cleavage, embryo morphokinetics, embryoscope, time-lapse imaging IntroductionAssisted reproductive technology (ART) may help infertile couples to realize their dream to have a child in their family, but pregnancy and live birth rates following in vitro fertilization (IVF) still remain low. It is ideal to identify viable embryos with the highest implantation potential to raise IVF success rates. In the traditional IVF practice, embryo assessments are mainly based on the morphologic observation and grade of embryologists at each stage of oocyte and embryonic development. Some features including oocyte and embryo quality, blastomere numbers and regularity, the percentage of fragmentation, and cytoplasmic granularity have been deined as prognostic indicators of successful pregnancy. This traditional embryo assessment method may have some detrimental efects on embryo growth because frequently opening and closing of incubators often cause to the change of embryo culture environmental steadiness. In order to reduce the inter-and intra-observer diference change, the time-lapse imaging (TLI) has been introduced into in vitro fertilization (IVF) laboratory. The application of time-lapse technology to the clinical IVF laboratory has supported more detailed observations on the embryo development researches quickly.The aim of this chapter is to determine whether TLI is useful for selection of "top quality" embryos for transfer to improve ART outcome rather than conventional morphological evaluation. The possible correlation between embryos' sex, embryo fragmentation, treatment protocols, diferent culture media, and embryo morphokinetics will be examined based on some new researches of TLI facilities. Furthermore, various algorithms and predictive models designed in ART cycles with TLI will be discussed.

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“…. 8-cell stage t x -t y : time between the x-cell to y-cell stage S 1 : time from appearance of the cleavage furrow to the completion of first cell division S 2 : time from the 3-to 4-cell stage S 3 : time from the 5-to 8-cell stage tM: time to morula stage tSB: time to start of blastulation tEB: time to expanded blastocyst Journal of Reproductive Biotechnology and Fertility (Motato et al, 2016). It should be mentioned here that while several groups consider multinucleation as a negative predictor of implantation/ pregnancy, there are reports that disagree with this.…”

Section: Tl Parametersmentioning

confidence: 99%

Time-lapse embryoscopy

Kovács

2016

Journal of Reproductive Biotechnology and Fertility

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Time-lapse (TL) embryo monitoring is the latest technology that is proposed for embryo evaluation and selection for transfer. TL technology enables us to collect significantly more information about the in vitro development of the embryos that can be obtained through the daily-once evaluation under the light microscope. In addition, the embryos do not need to be removed from the culture environment for this. The extra morphokinetic information and the undisturbed culture conditions could both be beneficial for the cultured embryo cohort. Many morphokinetic parameters have been tested in relation to variety of laboratory (e.g. blastocyst development) and clinical (implantation and live-birth rate) outcomes. Most of these studies are retrospective in nature and suffer from methodological problems (heterogeneous patient population, culture conditions not standardized, and small sample size). Several groups attempted to build algorithms, however, have not yet been confirmed externally as attempts so far could not reproduce the expected predictive abilities. Therefore, these algorithms cannot be universally accepted. The latest algorithm proposed for embryo selection was developed based on data from 24 clinics using local stimulation and laboratory procedures. It groups embryos into five categories (KIDScore) based on in and out of range kinetic events. The algorithm was tested in subsets of patients using various fertilization methods or culture conditions and its predictive ability remained the same. The authors, therefore, feel comfortable to recommend it for routine use in any laboratory using TL technology. There is, however, still limited prospective, randomized trial data testing the algorithms. This article reviews TL technology, retrospective and prospective reports on various morphokinetic parameters, and the benefits and shortcomings of currently available algorithms.

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Morphokinetic analysis and embryonic prediction for blastocyst formation through an integrated time-lapse system

Cited by 163 publications

References 47 publications

Impact of <b><i>FMR1</i></b> Pre-Mutation Status on Blastocyst Development in Patients Undergoing Pre-Implantation Genetic Diagnosis

Impact of <b><i>FMR1</i></b> Pre-Mutation Status on Blastocyst Development in Patients Undergoing Pre-Implantation Genetic Diagnosis

Embryo Morphokinetics Based on Time-Lapse Observation

Time-lapse embryoscopy

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