Improving embryo selection using a computer-automated time-lapse image analysis test plus day 3 morphology: results from a prospective multicenter trial
Improving embryo selection using a computer-automated time-lapse image analysis test plus day 3 morphology: results from a prospective multicenter trial
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DOI：
10.1016/j.fertnstert.2013.04.021
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发表时间：
2013-08-01
影响因子：
6.7
通讯作者：
Shen, Shehua
中科院分区：
文献类型：
--
作者：
Conaghan, Joe;Chen, Alice A.;Shen, Shehua
目的：评估第一个用于延时图像分析和囊胚预测的计算机自动化平台，并确定筛选信息如何帮助胚胎学家在第3天（D3）胚胎选择。设计：前瞻性、多中心、队列研究。环境：美国有五家试管婴儿诊所。患者：160名女性，>= 18岁，接受新鲜体外受精治疗，基础卵泡计数>= 8，基础FSH < 10 IU/mL, >= 8个正常受精卵母细胞。干预：采用一种无创试验，结合延时图像分析和细胞跟踪软件Eeva（早期胚胎活力评估），测量早期胚胎发育，并通过D3产生可用的囊胚预测。主要结局指标：与形态学加Eeva相比，经验丰富的胚胎学家单独使用D3形态学选择哪些胚胎可能发育成可用囊胚的能力有所提高。结果：经验丰富的胚胎学家使用Eeva结合D3形态学显著提高了他们识别将达到可用囊胚期的胚胎的能力（三位胚胎学家使用形态学与形态学加Eeva的特异性分别为59.7%对86.3%，41.9%对84.0%，79.5%对86.6%）。形态学和Eeva的辅助使用改善了胚胎选择，使胚胎学家能够更好地区分哪些胚胎不太可能发育成囊胚，特别有利于改善形态学良好的胚胎的选择。形态学和Eeva的辅助使用也减少了胚胎选择中的个体间变异。结论：先前的研究表明，与卵裂期移植相比，囊胚移植的着床率更高。在目前的胚胎分级过程中添加Eeva可能会提高卵裂期et的成功率。(c) 2013年，美国生殖医学学会。)
Objective: To assess the first computer-automated platform for time-lapse image analysis and blastocyst prediction and to determine how the screening information may assist embryologists in day 3 (D3) embryo selection.Design: Prospective, multicenter, cohort study.Setting: Five IVF clinics in the United States.Patient(s): One hundred sixty women >= 18 years of age undergoing fresh IVF treatment with basal antral follicle count >= 8, basal FSH < 10 IU/mL, and >= 8 normally fertilized oocytes.Intervention(s): A noninvasive test combining time-lapse image analysis with the cell-tracking software, Eeva (Early Embryo Viability Assessment), was used to measure early embryo development and generate usable blastocyst predictions by D3.Main Outcome Measure(s): Improvement in the ability of experienced embryologists to select which embryos are likely to develop to usable blastocysts using D3 morphology alone, compared with morphology plus Eeva.Result(s): Experienced embryologists using Eeva in combination with D3 morphology significantly improved their ability to identify embryos that would reach the usable blastocyst stage (specificity for each of three embryologists using morphology vs. morphology plus Eeva: 59.7% vs. 86.3%, 41.9% vs. 84.0%, 79.5% vs. 86.6%). Adjunctive use of morphology plus Eeva improved embryo selection by enabling embryologists to better discriminate which embryos would be unlikely to develop to blastocyst and was particularly beneficial for improving selection among good-morphology embryos. Adjunctive use of morphology plus Eeva also reduced interindividual variability in embryo selection.Conclusion(s): Previous studies have shown improved implantation rates for blastocyst transfer compared with cleavage-stage transfer. Addition of Eeva to the current embryo grading process may improve the success rates of cleavage-stage ETs. ((c) 2013 by American Society for Reproductive Medicine.)