Sequential embryo scoring as a predictor of aneuploidy in poor-prognosis patients

Optimal Embryo Selection: The Irreplaceable Role of the Embryologist in an Age of Advancing Technology

“…Overall, our study agrees with published data that have shown that both morphologic and morphokinetic parameters have a role in selecting blastocyst embryos for transfer [ 3 , 6 , 16 , 17 ] and even on day 3 can predict embryo competence. [ 7 , 8 ] However, when comparing morphologic to morphokinetic parameters on day 3, the expertise of an embryologist was superior to the morphokinetic model with an AUC closer to 1 (0.66 vs. 0.58 respectively).…”

“…Furthermore, one study showed that performing PGT did not improve live birth rates for patients with poor prognoses compared to embryo scoring alone. [ 3 ] Hence, grading of embryos is especially important for this group of patients.…”

Optimal Embryo Selection: The Irreplaceable Role of the Embryologist in an Age of Advancing Technology

“…Overall, our study agrees with published data that have shown that both morphologic and morphokinetic parameters have a role in selecting blastocyst embryos for transfer [ 3 , 6 , 16 , 17 ] and even on day 3 can predict embryo competence. [ 7 , 8 ] However, when comparing morphologic to morphokinetic parameters on day 3, the expertise of an embryologist was superior to the morphokinetic model with an AUC closer to 1 (0.66 vs. 0.58 respectively).…”

“…Furthermore, one study showed that performing PGT did not improve live birth rates for patients with poor prognoses compared to embryo scoring alone. [ 3 ] Hence, grading of embryos is especially important for this group of patients.…”

Could time-lapse embryo imaging reduce the need for biopsy and PGS?

“…While the advantage of determining embryonic aneuploidy as early as possible is obvious, and use of early cleavage timings alone would be a convenient and simplified approach, advocating a complete move to day 3 transfer may be a bit premature. Rather, the ability to utilize and combine multiple morphologic endpoint assessments throughout embryo development may further improve aneuploidy predictive ability [25]. Combining the endpoint timings from the two recent peerreviewed retrospective publications on morphokinetics and correlation to aneuploidy, using information from both pre-and post-MZT events, may improve predictive ability.…”

Effect of day 3 embryo cell number on the pregnancy and neonatal outcomes of day 4 single embryo transfer from fresh cycles

“…Faster developing embryos are often considered to have a higher probability of chromosomal abnormalities.Among the supporting evidence [21,32,33], one of the most recent studies was a 2015 embryo biopsy showing that > 9-cell embryos at day 3 were signi cantly associated with increased aneuploidy rates [21].However, Moayeri et al's [34] study concluded that embryo fragmentation, rather than cell number, can be a sensitive predictor of chromosomal normalcy or not.In another retrospective study, Zhao et al [30] also found that embryos of > 10-cell origin had a similar aneuploidy rate as those of 8-cell origin (55.6% vs. 55.9%).Pons et al [22] analyzed PGT-A data from a total of 4028 embryos and further con rmed that the ploidy of blastocysts from > 11-cell is comparable to that of 8-cell.Thus, the implantation potential of faster developing embryos may not be affected by their chromosomal status.All of the above studies classi ed > 10 cells as a group without further detailed grouping, while the present study further detailed > 10 cells into 10 ~ 13 cells and ≥ 14 cells groups. The results showed that D4 embryos with 10 ~ 13-cell at D3 had the highest pregnancy and live birth rate after transfer, while those with too fast embryo development (≥ 14 cells) tended to have lower pregnancy rates.The reduced implantation potential of too faster developing embryos may be associated with an increased abnormal cleavage behavior of direct division in too faster developing embryos,the exact reason for which is not known.Embryos with higher cell numbers have smaller blastomeres, and larger fragments can easily be mistaken for blastomeres, so some fragmented embryos are at risk of being mistaken for faster developing embryos.…”

Optimal Embryo Selection: The Irreplaceable Role of the Embryologist in an Age of Advancing Technology

“…Overall, our study agrees with published data that have shown that both morphologic and morphokinetic parameters have a role in selecting blastocyst embryos for transfer [ 3 , 6 , 16 , 17 ] and even on day 3 can predict embryo competence. [ 7 , 8 ] However, when comparing morphologic to morphokinetic parameters on day 3, the expertise of an embryologist was superior to the morphokinetic model with an AUC closer to 1 (0.66 vs. 0.58 respectively).…”

“…Furthermore, one study showed that performing PGT did not improve live birth rates for patients with poor prognoses compared to embryo scoring alone. [ 3 ] Hence, grading of embryos is especially important for this group of patients.…”

Could time-lapse embryo imaging reduce the need for biopsy and PGS?

“…While the advantage of determining embryonic aneuploidy as early as possible is obvious, and use of early cleavage timings alone would be a convenient and simplified approach, advocating a complete move to day 3 transfer may be a bit premature. Rather, the ability to utilize and combine multiple morphologic endpoint assessments throughout embryo development may further improve aneuploidy predictive ability [25]. Combining the endpoint timings from the two recent peerreviewed retrospective publications on morphokinetics and correlation to aneuploidy, using information from both pre-and post-MZT events, may improve predictive ability.…”

Effect of day 3 embryo cell number on the pregnancy and neonatal outcomes of day 4 single embryo transfer from fresh cycles

“…Faster developing embryos are often considered to have a higher probability of chromosomal abnormalities.Among the supporting evidence [21,32,33], one of the most recent studies was a 2015 embryo biopsy showing that > 9-cell embryos at day 3 were signi cantly associated with increased aneuploidy rates [21].However, Moayeri et al's [34] study concluded that embryo fragmentation, rather than cell number, can be a sensitive predictor of chromosomal normalcy or not.In another retrospective study, Zhao et al [30] also found that embryos of > 10-cell origin had a similar aneuploidy rate as those of 8-cell origin (55.6% vs. 55.9%).Pons et al [22] analyzed PGT-A data from a total of 4028 embryos and further con rmed that the ploidy of blastocysts from > 11-cell is comparable to that of 8-cell.Thus, the implantation potential of faster developing embryos may not be affected by their chromosomal status.All of the above studies classi ed > 10 cells as a group without further detailed grouping, while the present study further detailed > 10 cells into 10 ~ 13 cells and ≥ 14 cells groups. The results showed that D4 embryos with 10 ~ 13-cell at D3 had the highest pregnancy and live birth rate after transfer, while those with too fast embryo development (≥ 14 cells) tended to have lower pregnancy rates.The reduced implantation potential of too faster developing embryos may be associated with an increased abnormal cleavage behavior of direct division in too faster developing embryos,the exact reason for which is not known.Embryos with higher cell numbers have smaller blastomeres, and larger fragments can easily be mistaken for blastomeres, so some fragmented embryos are at risk of being mistaken for faster developing embryos.…”

Optimal Embryo Selection: The Irreplaceable Role of the Embryologist in an Age of Advancing Technology

“…Overall, our study agrees with published data that have shown that both morphologic and morphokinetic parameters have a role in selecting blastocyst embryos for transfer [ 3 , 6 , 16 , 17 ] and even on day 3 can predict embryo competence. [ 7 , 8 ] However, when comparing morphologic to morphokinetic parameters on day 3, the expertise of an embryologist was superior to the morphokinetic model with an AUC closer to 1 (0.66 vs. 0.58 respectively).…”

“…Furthermore, one study showed that performing PGT did not improve live birth rates for patients with poor prognoses compared to embryo scoring alone. [ 3 ] Hence, grading of embryos is especially important for this group of patients.…”

Could time-lapse embryo imaging reduce the need for biopsy and PGS?

“…While the advantage of determining embryonic aneuploidy as early as possible is obvious, and use of early cleavage timings alone would be a convenient and simplified approach, advocating a complete move to day 3 transfer may be a bit premature. Rather, the ability to utilize and combine multiple morphologic endpoint assessments throughout embryo development may further improve aneuploidy predictive ability [25]. Combining the endpoint timings from the two recent peerreviewed retrospective publications on morphokinetics and correlation to aneuploidy, using information from both pre-and post-MZT events, may improve predictive ability.…”

Effect of day 3 embryo cell number on the pregnancy and neonatal outcomes of day 4 single embryo transfer from fresh cycles

“…Faster developing embryos are often considered to have a higher probability of chromosomal abnormalities.Among the supporting evidence [21,32,33], one of the most recent studies was a 2015 embryo biopsy showing that > 9-cell embryos at day 3 were signi cantly associated with increased aneuploidy rates [21].However, Moayeri et al's [34] study concluded that embryo fragmentation, rather than cell number, can be a sensitive predictor of chromosomal normalcy or not.In another retrospective study, Zhao et al [30] also found that embryos of > 10-cell origin had a similar aneuploidy rate as those of 8-cell origin (55.6% vs. 55.9%).Pons et al [22] analyzed PGT-A data from a total of 4028 embryos and further con rmed that the ploidy of blastocysts from > 11-cell is comparable to that of 8-cell.Thus, the implantation potential of faster developing embryos may not be affected by their chromosomal status.All of the above studies classi ed > 10 cells as a group without further detailed grouping, while the present study further detailed > 10 cells into 10 ~ 13 cells and ≥ 14 cells groups. The results showed that D4 embryos with 10 ~ 13-cell at D3 had the highest pregnancy and live birth rate after transfer, while those with too fast embryo development (≥ 14 cells) tended to have lower pregnancy rates.The reduced implantation potential of too faster developing embryos may be associated with an increased abnormal cleavage behavior of direct division in too faster developing embryos,the exact reason for which is not known.Embryos with higher cell numbers have smaller blastomeres, and larger fragments can easily be mistaken for blastomeres, so some fragmented embryos are at risk of being mistaken for faster developing embryos.…”