Reproducibility of a time-lapse embryo selection model based on morphokinetic data in a sequential culture media setting

Yalçınkaya, Ender; Ergin, E.; Çalışkan, Eray; Oztel, Z.; Özay, A.; Ozornek, H.

doi:10.5152/jtgga.2014.13068

Cited by 23 publications

(23 citation statements)

References 19 publications

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“…Naturally, in those laboratories that do not have access to a data-set allowing in-house derivation of predictive models, externally developed versions may be adopted, a decision which has been cautioned (Kirkegaard et al, 2013a;Yalçınkaya et al, 2014). Evidence of the benefits to using embryo-scoring algorithms can be seen clearly in the literature where the earliest publications regarding TLS aimed to assess the safety of the systems (Nakahara et al, 2010;Cruz et al, 2011;Freour et al, 2012;Kirkegaard et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Embryos cultured in a time-lapse system result in superior treatment outcomes: a strict matched pair analysis

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Embryos cultured in a time-lapse system result in superior treatment outcomes: a strict matched pair analysis

et al. 2016

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“… Lemmen et al ., 2008 ; Wong et al ., 2010 ; Meseguer et al ., 2011 , 2012 ; Azzarello et al ., 2012 ; Cruz et al ., 2012 ; Dal Canto et al ., 2012 ; Rubio et al ., 2012 , 2014 ; Chamayou et al ., 2013 ; Conaghan et al ., 2013 ; Freour et al ., 2013 ; Campbell et al ., 2013a , 2013b ; Aguilar et al ., 2014 ; Liu et al ., 2014 , 2016 ; VerMilyea et al . 2014 ; Yalçınkaya et al ., 2014 ; Basile et al ., 2015 ; Cetinkaya et al ., 2015 ; Gardner et al ., 2015 ; Milewski et al ., 2015 ; Yang et al ., 2015 ).…”

Section: Introductionunclassified

Development of a generally applicable morphokinetic algorithm capable of predicting the implantation potential of embryos transferred on Day 3

Petersen¹,

Boel²,

Montag³

et al. 2016

Hum. Reprod.

192

162

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STUDY QUESTIONCan a generally applicable morphokinetic algorithm suitable for Day 3 transfers of time-lapse monitored embryos originating from different culture conditions and fertilization methods be developed for the purpose of supporting the embryologist's decision on which embryo to transfer back to the patient in assisted reproduction?SUMMARY ANSWERThe algorithm presented here can be used independently of culture conditions and fertilization method and provides predictive power not surpassed by other published algorithms for ranking embryos according to their blastocyst formation potential.WHAT IS KNOWN ALREADYGenerally applicable algorithms have so far been developed only for predicting blastocyst formation. A number of clinics have reported validated implantation prediction algorithms, which have been developed based on clinic-specific culture conditions and clinical environment. However, a generally applicable embryo evaluation algorithm based on actual implantation outcome has not yet been reported.STUDY DESIGN, SIZE, DURATIONRetrospective evaluation of data extracted from a database of known implantation data (KID) originating from 3275 embryos transferred on Day 3 conducted in 24 clinics between 2009 and 2014. The data represented different culture conditions (reduced and ambient oxygen with various culture medium strategies) and fertilization methods (IVF, ICSI). The capability to predict blastocyst formation was evaluated on an independent set of morphokinetic data from 11 218 embryos which had been cultured to Day 5.PARTICIPANTS/MATERIALS, SETTING, METHODSThe algorithm was developed by applying automated recursive partitioning to a large number of annotation types and derived equations, progressing to a five-fold cross-validation test of the complete data set and a validation test of different incubation conditions and fertilization methods. The results were expressed as receiver operating characteristics curves using the area under the curve (AUC) to establish the predictive strength of the algorithm.MAIN RESULTS AND THE ROLE OF CHANCEBy applying the here developed algorithm (KIDScore), which was based on six annotations (the number of pronuclei equals 2 at the 1-cell stage, time from insemination to pronuclei fading at the 1-cell stage, time from insemination to the 2-cell stage, time from insemination to the 3-cell stage, time from insemination to the 5-cell stage and time from insemination to the 8-cell stage) and ranking the embryos in five groups, the implantation potential of the embryos was predicted with an AUC of 0.650. On Day 3 the KIDScore algorithm was capable of predicting blastocyst development with an AUC of 0.745 and blastocyst quality with an AUC of 0.679. In a comparison of blastocyst prediction including six other published algorithms and KIDScore, only KIDScore and one more algorithm surpassed an algorithm constructed on conventional Alpha/ESHRE consensus timings in terms of predictive power.LIMITATIONS, REASONS FOR CAUTIONSome morphological assessments were not available and co...

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“…Some authors have compared embryo evaluation algorithms to the traditional morphological assessment performed by embryologists during development and the final evaluation from a designated embryologist before embryo transfer (Storr et al, 2018;Adamson et al, 2016). Other authors recommended that every laboratory should have their own embryo selection criteria and develop independent predictive algorithms based on their own data (Yalçınkaya et al, 2014). On the other hand, the randomized prospective study published by Goodman et al (2016) did not find statistically significant differences in the clinical outcomes of embryos transferred after assessment in a time-lapse incubator; however, the results of the study were inconclusive.…”

Section: Introductionmentioning

confidence: 99%

The KidscoreTM D5 algorithm as an additional tool to morphological assessment and PGT-A in embryo selection: a time-lapse study

Gazzo¹,

Peña²,

Valdéz³

et al. 2019

JBRA Assisted Reproduction

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Objective: To evaluate the use of implantation data algorithm KIDscore TM D5 (Vitrolife ® , Canada) as an additional tool for morphological assessment and preimplantation genetic testing for aneuploidies (PGT-A) to improve implantation and ongoing pregnancy rates. Materials and methods: This study looked into 912 embryos from 270 patients who underwent IVF at the IN-MATER Fertility Clinic in Lima, Peru, between October 2016 and June 2018. All embryos were cultured for up to five or six days in an Embryoscope ® time-lapse incubator (Vitrolife ® , Canada) and evaluated based on the KIDscore TM D5 algorithm (KS5). Biopsies for PGT-A screening were performed in 778 (85.31%) embryos. A total of 184 single embryo transfers (68% of patients) were performed during the study period and the embryos transferred were divided into four groups: 1) euploid embryos transferred without consideration to their KS5 scores (n=86); 2) euploid embryos transferred considering their KS5 scores (n=48); 3) embryos transferred without consideration to their KS5 scores and that were not evaluated by PGT-A (n=40); and 4) embryos transferred considering their KS5 scores and that were not evaluated by PGT-A (n=10). Implantation and ongoing pregnancy rates were compared between the groups and between euploid embryos with the highest KS5 scores (KS5=6, n=25) and euploid embryos with the lowest KS5 scores (KS5=1, n=51). The correlations between KS5 scores and embryo euploidy rates were also evaluated. Results: Euploid embryo transfers in which KS5 scores were considered in the selection process had significantly higher Implantation and ongoing pregnancy rates compared to euploid embryo transfers in which selection was based on morphology (75.00% vs. 50.00%; p=0.002 and 66.66% vs. 48.83%; p=0.037, respectively). Additionally, implantation rates were significantly higher for blastocysts with the highest KS5 score (KS5=6) compared to blastocysts with the lowest score (KS5=1) (80.00% vs. 49.02%; p=0.045). Ongoing pregnancy rates were not significantly different (72.00% vs. 47.06%; p=0.105). Euploidy rates were significantly higher in the group of embryos with KS5=6 than in the group of embryos with KS5=1 (61.88% vs. 48.33%; p=0.006). Conclusion: Embryo selection based on the KS5 algorithm score improved the implantation rates of single euploid blastocyst transfers. Furthermore, embryos with the highest KS5 score had a higher probability of being euploid and implanting.

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Reproducibility of a time-lapse embryo selection model based on morphokinetic data in a sequential culture media setting

Cited by 23 publications

References 19 publications

Embryos cultured in a time-lapse system result in superior treatment outcomes: a strict matched pair analysis

Embryos cultured in a time-lapse system result in superior treatment outcomes: a strict matched pair analysis

Development of a generally applicable morphokinetic algorithm capable of predicting the implantation potential of embryos transferred on Day 3

The KidscoreTM D5 algorithm as an additional tool to morphological assessment and PGT-A in embryo selection: a time-lapse study

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