Selecting embryos with the highest implantation potential using data mining and decision tree based on classical embryo morphology and morphokinetics

Carrasco, Beatriz; Arroyo, Gemma; Gil, Yolanda Rodríguez; Gómez, Ma José; Rodríguez, Ignacio; Barri, Pedro N.; Veiga, Anna; Boada, Montserrat

doi:10.1007/s10815-017-0955-x

Cited by 37 publications

(20 citation statements)

References 43 publications

(51 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several authors have indicated that morphokinetic parameters are characteristic of blastocyst formation (Wong et al , 2010; Conaghan et al , 2013; Milewski et al , 2015; Motato et al , 2016) and pregnancy or implantation (Meseguer et al , 2011; VerMilyea et al , 2014; Basile et al , 2015; Liu et al , 2016; Milewski et al , 2016; Motato et al , 2016; Petersen et al , 2016; Carrasco et al , 2017) but the general applicability of former morphokinetic algorithms for pregnancy, implantation or birth prediction is currently subject to controversy. Some authors who were not involved in developing the algorithms have maintained that time-lapse algorithms have a significantly higher predictive power than conventional scoring (Adamson, 2016; Kieslinger et al , 2016; Adolfsson et al , 2018; Liu et al , 2018), while other authors were unable to show a significant predictive capability for pregnancy, implantation or live birth (Kirkegaard et al , 2014; Yalçınkaya et al , 2014; Fréour et al , 2015; Ahlstrom et al , 2016; Goodman et al , 2016; Barrie et al , 2017; Adolfsson et al , 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Over the last few years, time-lapse imaging (TLI) systems have been developed, giving embryologists the chance to use additional non-invasive criteria. Several markers of embryonic kinetics (Lemmen et al , 2008; Abeyta and Behr, 2014; Armstrong et al , 2015) have been studied from the first cleavage onwards, and some of them have been applied in decisional algorithms for embryo transfer (Meseguer et al , 2011; VerMilyea et al , 2014; Basile et al , 2015; Liu et al , 2016; Milewski et al , 2016; Petersen et al , 2016; Carrasco et al , 2017). However, there is still a need to determine whether kinetic parameters can be used as independent criteria to improve embryo selection (Goodman et al , 2016; Petersen et al , 2016; Armstrong et al , 2018).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Can novel early non-invasive biomarkers of embryo quality be identified with time-lapse imaging to predict live birth?

et al. 2019

View full text Add to dashboard Cite

STUDY QUESTION Can time-lapse imaging systems make it possible to identify novel early non-invasive biomarkers to predict live birth? SUMMARY ANSWER From mostly high-grade embryos, out of 35 morphometric, morphologic and morphokinetic variables, only pronuclei (PN) position at time of PN juxtaposition and the absence of multinucleated blastomeres at the 2-cell stage (MNB2cell), were potentially associated with live birth. WHAT IS KNOWN ALREADY Previous studies indicate that some kinetic markers may be predictive of blastocyst development and embryonic implantation. Certain teams have suggested including some of them in decisional algorithms for embryo transfers. STUDY DESIGN, SIZE, DURATION Using a time-lapse incubator (EmbryoScope, Unisense FertiliTech), we retrospectively explored the associations between the morphometric, morphologic and morphokinetic parameters of oocytes, zygotes and embryos, and their associations with live birth. This study assessed 232 embryos from single embryo transfers after ICSI cycles performed between January 2014 and December 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS The morphometric, morphologic and morphokinetic parameters (18, 4 and 13, respectively) of oocytes, zygotes and early embryos were studied retrospectively. The associations between these parameters were examined using a Spearman’s correlation, Mann–Whitney or chi-squared test as appropriate. We examined whether these parameters were associated with outcomes in univariate and multivariate logistic regression analyses. MAIN RESULTS AND THE ROLE OF CHANCE Central PN juxtaposition was associated with a 2-fold increase in the odds of live birth (OR = 2.20; 95% CI, [1.26–3.89]; P = 0.006), while the presence of MNB2cell was associated with half the odds of live birth (OR = 0.51; 95% CI, [0.27–0.95]; P = 0.035). These two parameters were independent of embryo kinetics. The 33 remaining parameters had no significant association with the capacity of transferred embryos to develop to term. LIMITATIONS, REASONS FOR CAUTION Even though the population size was relatively small, our analyses were based on homogeneous cycles, i.e. young women whose transferred embryos were found to be high-grade according to conventional morphology evaluation. In addition, our conclusions were established from a specific, highly selected population, so other study populations, such as women in an older age bracket, may yield different results. Finally, because we assessed day 2/3 transfers, our findings cannot be generalized to embryos cultured up to the blastocyst stage. WIDER IMPLICATIONS OF THE FINDINGS It would be interesting to explore, prospectively, whether PN localisation is a relevant measure to predict embryo development when added into further algorithms and whether this parameter could be suitable for use in other IVF clinics. Further studies are needed, notably to explore the added value of timing evaluation in cohorts of embryos with low or intermediate morphology grade, as well as in other maternal populations (i.e. older women). STUDY FUNDING/COMPETING INTEREST(S) No external funding was used for this study. P. Sagot received funding from the following commercial companies: Merck Serono, Finox Biotech, Ferring, MSD France SAS, Teva Sante ́ SAS, Allergan France, Gedeon Richter France, Effik S.A., Karl Storz Endoscopie France, GE Medical Systems SCS, Laboratoires Genevrier, H.A.C. Pharma and Ipsen. All the authors confirm that none of this funding was used to support the research in this study. There are no patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the journal policies on sharing data and materials.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Can novel early non-invasive biomarkers of embryo quality be identified with time-lapse imaging to predict live birth?

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The evaluation of fertilization at a single time point, such as by observation of patterns of nucleolar precursor bodies (NPBs) or the presence of halos in cytoplasm, may predict IVF treatment outcome, but the effect is not always as expected [11,12]. Time-lapse embryo imaging enables non-invasive observation and setting of evaluation markers such as polar body extrusion, pronuclear formation, and cleavage times and patterns, as well as enabling identification of embryo quality and prediction of the pregnancy/implantation rate [13,14]. In-depth study of the fertilization process by time-lapse imaging shows a difference between normal and abnormal embryos in the mean duration of pronuclei fading (PNF) [15,16].…”

Section: Discussionmentioning

confidence: 99%

Does polycystic ovary syndrome affect morphokinetics or abnormalities in early embryonic development?

Lê

Nguyen

et al. 2019

European Journal of Obstetrics & Gynecology and Reproductiv

View full text Add to dashboard Cite

Objectives This study aimed to investigate whether oocyte retrieval from PCOS patients affects the morphokinetics or the incidence of abnormalities in early embryonic development, using time-lapse imaging analysis. Methods This was a prospective study in total of 39 PCOS patients and 67 women with normal ovarian function, underwent a GnRH antagonist protocol of controlled ovarian stimulation and fertilization by ICSI. 402 zygotes from the PCOS group and 449 zygotes from the control group were observed by time-lapse monitoring for 48 h following sperm injection. Results Patients with PCOS showed a significantly higher number of retrieved oocytes, and a significantly higher number of metaphase II oocytes per cycle than that of the non-PCOS group (18.85 ± 9.41 vs. 11.48 ± 5.51 and 14.97 ± 7.43 vs. 9.51 ± 4.7, respectively). However, oocyte maturation rate and morphologically assessed embryo quality did not differ between two groups. After 48 h of the embryo culture using time-lapse video recording, most of the embryos in both groups had reached the 4-cell stage (353/449 vs. 314/402 embryos). There were no significant differences between the control and PCOS group regarding the time-points of the successive events in early embryonic development from the appearance of 2 polar bodies to the 6-cell stage. However, the percentage of t2 stages which fell in “optimal range” (>24 h and ≤28 h) was significantly lower in the PCOS group than in the control group (37.8% vs. 48.1%, P = 0.004). The proportion of embryos manifesting abnormal fertility, multinucleation, direct cleavage and reverse cleavage were not significantly different between the two groups. Conclusion Our data indicated that PCOS does not affect the morphokinetics or incidence of abnormalities in early embryonic development.

show abstract

“…Besides, DT can be combined with other decision techniques to improve the performance of the model. Carrasco et al (2017) developed a hierarchical model based on data mining and used DT to determine optimal embryonic morphokinetic parameters, which can make predictions for the selection of human embryos. The researchers found that the most predictive parameter is the classical morphological score.…”

Section: Overview Of the Ai In Reproductive Medicinementioning

confidence: 99%

“…Additionally, embryo assessment using the dynamic monitoring system (Time-Lapse (TL)) provides continuous information on the embryos’ developmental stage and morphokinetics, though the time-lapse algorithms remains questionable (Storr et al 2018); some researchers do noy consider it as evidence of the benefits for embryo election (Kaser & Racowsky 2014, Armstrong et al 2018). Carrasco et al (2017) retrospectively analyzed 800 human embryos with known implantation data in an incubator with Time-Lapse system. They developed a model based on the analysis of morphokinetic parameters and the embryo morphology assessment on D3.…”

Section: Ai Applications In Reproductive Medicinementioning

confidence: 99%

Artificial intelligence in reproductive medicine

et al. 2019

View full text Add to dashboard Cite

Artificial intelligence (AI) has experienced rapid growth over the past few years, moving from the experimental to the implementation phase in various fields, including medicine. Advances in learning algorithms and theories, the availability of large datasets and improvements in computing power have contributed to breakthroughs in current AI applications. Machine learning (ML), a subset of AI, allows computers to detect patterns from large complex datasets automatically and uses these patterns to make predictions. AI is proving to be increasingly applicable to healthcare, and multiple machine learning techniques have been used to improve the performance of assisted reproductive technology (ART). Despite various challenges, the integration of AI and reproductive medicine is bound to give an essential direction to medical development in the future. In this review, we discuss the basic aspects of AI and machine learning, and we address the applications, potential limitations and challenges of AI. We also highlight the prospects and future directions in the context of reproductive medicine.

show abstract

Selecting embryos with the highest implantation potential using data mining and decision tree based on classical embryo morphology and morphokinetics

Abstract: In our decision tree, the classical morphological score is the most predictive parameter. Among embryos with better morphological scores, morphokinetics permits deselection of embryos with the lowest implantation potential.

Cited by 37 publications

References 43 publications

Can novel early non-invasive biomarkers of embryo quality be identified with time-lapse imaging to predict live birth?

Can novel early non-invasive biomarkers of embryo quality be identified with time-lapse imaging to predict live birth?

Does polycystic ovary syndrome affect morphokinetics or abnormalities in early embryonic development?

Artificial intelligence in reproductive medicine

Contact Info

Product

Resources

About