Intra- and interobserver analysis in the morphological assessment of early stage embryos during an IVF procedure: a multicentre study

Abstract

BackgroundQuality control programs are necessary to maintain good clinical practice. Embryo grading has been described as one of the external quality assurance schemes. Although the evaluation of embryos is based on the assessment of morphological characteristics, considerable intra- and inter-observer variability has been described. In this multicentre study, the variability in the embryo evaluation has been evaluated using morphological characteristics on day 1, day 2 and day 3 of embryo development.MethodsFive embryologists of four different IVF centers participated in this study. Multilevel images of embryos were presented on a website at different time points to evaluate intra-and inter-observer agreement in the assessment of embryo morphology. The embryos were evaluated on day 1, day 2 and day 3 of their development and each embryologist had to decide if the embryo had to be transferred, cryopreserved or discarded.ResultsBoth intra-observer agreement and inter-observer agreement were good to excellent for the position of the pronuclei on day 1, the number of blastomeres on day 2 and day 3 and the clinical decision (transfer, cryopreservation, discard). For all other characteristics (size of pronuclei, presence of cytoplasomic halo, degree of fragmentation and size of blastomeres) the intra- and inter-observer agreement was moderate to very poor.ConclusionsMono- or multicentre quality control on embryo scoring by morphological assessment can easily be performed through the design of a simple website. In the future the website design can be adapted to generate statistical feedback upon scoring and can even include a training module.

Does sperm origin affect embryo morphokinetic parameters?

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A highly sensitive electrochemiluminescence immunoassay for detecting human embryonic human chorionic gonadotropin in spent embryo culture media during IVF-ET cycle

“…At the same time, multiple pregnancies appear due to the transfer of more than one embryo, and this will cause socio-economic setbacks as well as numerous complications of mothers and babies. Moreover, the visual scoring of embryos is subjective; the intraand inter-investigators agreement on the grading could be fair to poor [8]. As a result, other methods or techniques are in need for assessing embryo viability.…”

Methods for Spatio-Temporal Analysis of Embryo Cleavage In Vitro

“…A small amount of video data may be analyzed manually, but this method quickly becomes cumbersome and time-consuming and automatic or semiautomatic methods are necessary. Manual evaluation of images is also prone to errors and inter-observer variability [49,50]. It is often beneicial if the intended analysis can be considered already at the image capture stage so that acquisition, image quality, and hardware set up can be optimized upfront.…”