Retrospective analysis of outcomes after IVF using an aneuploidy risk model derived from time-lapse imaging without PGS

Abstract

Time-lapse imaging of human preimplantation IVF embryos has enabled objective algorithms based on novel observations of development (morphokinetics) to be used for clinical selection of embryos. Embryo aneuploidy, a major cause of IVF failure, has been correlated with specific morphokinetic variables used previously to develop an aneuploidy risk classification model. The purpose of this study was to evaluate the effectiveness and potential impact of this model for unselected IVF patients without biopsy and preimplantation genetic screening (PGS). Embryo outcomes - no implantation, fetal heart beat (FHB) and live birth (LB) - of 88 transferred blastocysts were compared according to calculated aneuploidy risk classes (low, medium, high). A significant difference was seen for FHB (P<0.0001) and LB (P<0.01) rates between embryos classified as low and medium risk. Within the low-risk class, relative increases of 74% and 56%, compared with rates for all blastocysts, were observed for FHB and LB respectively. The area under the receiver operating characteristic curve was 0.75 for FHB and 0.74 for LB. This study demonstrates the clinical relevance of the aneuploidy risk classification model and introduces a novel, non-invasive method of embryo selection to yield higher implantation and live birth rates without PGS.

Abnormally cleaving embryos are able to produce live births: a time-lapse study

“…Such a mechanism could explain our results, but further future studies need to be undertaken to elucidate the molecular nature of the mechanism(s). Campbell et al [20] further depicted no significant differences between aneuploid and euploid embryos in irregular division patterns (Bdirect^or Brapid^division defined as being less than of 5-h duration), which may further support our contention. We additionally studied the implantation rate, clinical pregnancy rate, ongoing pregnancy rate, and live birth rate in the AC 1-3c , AC 2-4c , AC 3-5c , and AC 4-6c groups as illustrated in Table 4.…”

Morphokinetic parameters of early embryo development via time lapse monitoring and their effect on embryo selection and ICSI outcomes: a prospective cohort study

“…Recent studies reported information on the association of the type of fertilization [22], the IVF protocol used [23], female obesity [24], and smoking [25] on embryo kinetics and development. Interestingly, the sensitivity and specificity of the modality in terms of predicting the progression to the blastocyst stage was >90 % by measuring parameters at day 2 after fertilization, before embryonic genome activation [26,27], while the bad prognosis of good-performing but unviable embryos reaches a specificity of 100 % [28]; moreover, the area under the receiver operating characteristic curve has been reported to be 0.74 for live birth [29] with high intra-and inter-observer correlation [30].…”

Effect of red light on the development and quality of mammalian embryos

“…However, most studies only use light intensity to quantify illumination effect on embryos [3,15,16]. Light at longer wavelength carries lower energy and red light is recommended as a safe illumination source for embryo observation systems [15] and is now routinely applied in timelapse incubation systems [11,12,[19][20][21]. However, the maximum tolerance of embryos to red light is unknown, and no comparisons have yet been made of an eventual effect of maximizing light exposures to obtain even more morphological details over a full pre-implantation period in-vitro, i.e.…”