Using the Society for Assisted Reproductive Technology Clinic Outcome System morphological measures to predict live birth after assisted reproductive technology

Abstract

Objective To model morphologic assessments of embryo quality predictive of live birth Design Longitudinal cohort using cycles reported in the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System between 2007 and 2011. Setting Clinic-based data Patients Fresh autologous ART cycles with embryo transfers on day 3 or day 5 and morphologic assessments reported (25,409 cycles with one embryo transferred and 96,093 cycles with two embryos transferred). Live birth rates were modeled by morphological assessments using backward-stepping logistic regression for cycle 1 and over five cycles, separately for day 3 and day 5 transfers and number of embryos transferred (1 or 2). Additional models for each day of transfer also included number of oocytes retrieved and number of embryos cryopreserved. Interventions None Main Outcome Measures Live births Results Morphologic assessments of grade, stage, fragmentation, and symmetry were significant for the day 3 models; grade, stage and trophectoderm were significant in the day 5 model; inner cell mass was significant in the models when two embryos were transferred. Number of oocytes retrieved and number of embryos cryopreserved were significant for both day 3 and day 5 models. Conclusions These findings confirm the significant association between embryo quality parameters reported to SART CORS and live birth rate following ART.

Quality control and standardization of embryo morphology scoring and viability markers

“…They found that live birth was positively correlated with increasing cell number up to eight cells, and negatively with increasing fragmentation and blastomere asymmetry (size and/or shape). These data are consistent with those recently presented by Luke et al (2014), who performed an analysis of 121,500 cycles registered in the SART CORS database with single or double embryo transfers day 3 or day 5. They found that the grade, stage, fragmentation and symmetry were significant predictors of live birth for the day 3 model, while grade, stage and trophectoderm were significant predictors in the day 5 model.…”

“…These national embryo morphology data have now been evaluated and validated regarding day 3 embryo morphology and live birth outcome (Luke et al, 2014;Racowsky et al, 2009;Vernon et al, 2011). Vernon et al found that in 16,550 double-embryo transfers (DET) on day 3 with equally graded embryos, both live birth and multiple birth rate were positively correlated with the score (good, fair, poor) of the embryo.…”

Factors associated with the use of elective single-embryo transfer and pregnancy outcomes in the United States, 2004–2012

“…However, these data are not available in the SART CORS and residual confounding is possible. Recently, embryo morphology and quality have been included in SART CORS (44). However, embryo grading is subjective and varies significantly among institutions (45).…”

Follicular fluid and mural granulosa cells microRNA profiles vary in in vitro fertilization patients depending on their age and oocyte maturation stage

“…The quality of IVF embryos is usually evaluated by morphological parameters such as cell number, size, DNA fragmentation, and organelle morphological abnormalities (22). These characteristics, as well as embryo cleavage times (also known as morphokinetics), have been associated with lower implantation and pregnancy rates (23).…”