Skip to main content
Erschienen in: Journal of Assisted Reproduction and Genetics 1/2015

01.01.2015 | Assisted Reproduction Technologies

Using the Eeva Test™ adjunctively to traditional day 3 morphology is informative for consistent embryo assessment within a panel of embryologists with diverse experience

verfasst von: Michael P. Diamond, Vaishali Suraj, Erica J. Behnke, Xinli Yang, Marlane J. Angle, Jaclyn C. Lambe-Steinmiller, Rachel Watterson, Kelly Athayde Wirka, Alice A. Chen, Shehua Shen

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 1/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Since many transferred, good morphology embryos fail to implant, technologies to identify embryos with high developmental potential would be beneficial. The Eeva™ (Early Embryo Viability Assessment) Test, a prognostic test based on automated detection and analysis of time-lapse imaging information, has been shown to benefit embryo selection specificity for a panel of three highly experienced embryologists (Conaghan et al., 2013). Here we examined if adjunctive use of Eeva Test results following morphological assessment would allow embryologists with diverse clinical backgrounds to consistently improve the selection of embryos with high developmental potential.

Methods

Prospective, double-blinded multi-center study with 54 patients undergoing blastocyst transfer cycles consented to have embryos imaged using the Eeva System, which automatically measures key cell division timings and categorizes embryos into groups based on developmental potential. Five embryologists of diverse clinical practices, laboratory training, and geographical areas predicted blastocyst formation using day 3 morphology alone and day 3 morphology followed by Eeva Test results. Odds ratio (OR) and diagnostic performance measures were calculated by comparing prediction results to true blastocyst outcomes.

Results

When Eeva Test results were used adjunctively to traditional morphology to help predict blastocyst formation among embryos graded good or fair on day 3, the OR was 2.57 (95 % CI=1.88–3.51). The OR using morphology alone was 1.68 (95 % CI=1.29–2.19). Adjunct use of the Eeva Test reduced the variability in prediction performance across all five embryologists: the variability was reduced from a range of 1.06 (OR=1.14 to 2.20) to a range of 0.45 (OR=2.33 to 2.78).

Conclusions

The Eeva Test, an automated, time-lapse enabled prognostic test, used adjunctively with morphology, is informative in helping embryologists with various levels of experience select embryos with high developmental potential.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Van Montfoort AP, Dumoulin JC, Kester AD, Evers JL. Early cleavage is a valuable addition to existing embryo selection parameters: a study using single embryo transfers. Hum Reprod. 2004;19(9):2103–8. doi:10.1093/humrep/deh385.PubMedCrossRef Van Montfoort AP, Dumoulin JC, Kester AD, Evers JL. Early cleavage is a valuable addition to existing embryo selection parameters: a study using single embryo transfers. Hum Reprod. 2004;19(9):2103–8. doi:10.​1093/​humrep/​deh385.PubMedCrossRef
4.
Zurück zum Zitat Paternot G, Devroe J, Debrock S, D’Hooghe TM, Spiessens C. Intra- and inter-observer analysis in the morphological assessment of early-stage embryos. Reprod Biol Endocrinol: RB&E. 2009;7:105. doi:10.1186/1477-7827-7-105.CrossRef Paternot G, Devroe J, Debrock S, D’Hooghe TM, Spiessens C. Intra- and inter-observer analysis in the morphological assessment of early-stage embryos. Reprod Biol Endocrinol: RB&E. 2009;7:105. doi:10.​1186/​1477-7827-7-105.CrossRef
6.
Zurück zum Zitat Cruz M, Gadea B, Garrido N, Pedersen KS, Martinez M, Perez-Cano I, et al. Embryo quality, blastocyst and ongoing pregnancy rates in oocyte donation patients whose embryos were monitored by time-lapse imaging. J Assist Reprod Genet. 2011;28(7):569–73. doi:10.1007/s10815-011-9549-1.PubMedCentralPubMedCrossRef Cruz M, Gadea B, Garrido N, Pedersen KS, Martinez M, Perez-Cano I, et al. Embryo quality, blastocyst and ongoing pregnancy rates in oocyte donation patients whose embryos were monitored by time-lapse imaging. J Assist Reprod Genet. 2011;28(7):569–73. doi:10.​1007/​s10815-011-9549-1.PubMedCentralPubMedCrossRef
11.
Zurück zum Zitat Sazonova A, Kallen K, Thurin-Kjellberg A, Wennerholm UB, Bergh C. Neonatal and maternal outcomes comparing women undergoing two in vitro fertilization (IVF) singleton pregnancies and women undergoing one IVF twin pregnancy. Fertil Steril. 2013;99(3):731–7. doi:10.1016/j.fertnstert.2012.11.023.PubMedCrossRef Sazonova A, Kallen K, Thurin-Kjellberg A, Wennerholm UB, Bergh C. Neonatal and maternal outcomes comparing women undergoing two in vitro fertilization (IVF) singleton pregnancies and women undergoing one IVF twin pregnancy. Fertil Steril. 2013;99(3):731–7. doi:10.​1016/​j.​fertnstert.​2012.​11.​023.PubMedCrossRef
12.
Zurück zum Zitat Practice Committees of the American Society for Reproductive M, the Society for Assisted Reproductive T. Blastocyst culture and transfer in clinical-assisted reproduction: a committee opinion. Fertility and sterility. 2013;99(3):667–72. doi:10.1016/j.fertnstert.2013.01.087. Practice Committees of the American Society for Reproductive M, the Society for Assisted Reproductive T. Blastocyst culture and transfer in clinical-assisted reproduction: a committee opinion. Fertility and sterility. 2013;99(3):667–72. doi:10.​1016/​j.​fertnstert.​2013.​01.​087.
14.
Zurück zum Zitat Conaghan J, Chen AA, Willman SP, Ivani K, Chenette PE, Boostanfar R, et al. Improving embryo selection using a computer-automated time-lapse image analysis test plus day 3 morphology: results from a prospective multicenter trial. Fertil Steril. 2013;100(2):412–9 e5. doi:10.1016/j.fertnstert.2013.04.021.PubMedCrossRef Conaghan J, Chen AA, Willman SP, Ivani K, Chenette PE, Boostanfar R, et al. Improving embryo selection using a computer-automated time-lapse image analysis test plus day 3 morphology: results from a prospective multicenter trial. Fertil Steril. 2013;100(2):412–9 e5. doi:10.​1016/​j.​fertnstert.​2013.​04.​021.PubMedCrossRef
15.
Zurück zum Zitat Yang Z, Liu J, Collins GS, Salem SA, Liu X, Lyle SS, et al. Selection of single blastocysts for fresh transfer via standard morphology assessment alone and with array CGH for good prognosis IVF patients: results from a randomized pilot study. Mol Cytogenet. 2012;5(1):24. doi:10.1186/1755-8166-5-24.PubMedCentralPubMedCrossRef Yang Z, Liu J, Collins GS, Salem SA, Liu X, Lyle SS, et al. Selection of single blastocysts for fresh transfer via standard morphology assessment alone and with array CGH for good prognosis IVF patients: results from a randomized pilot study. Mol Cytogenet. 2012;5(1):24. doi:10.​1186/​1755-8166-5-24.PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Forman EJ, Upham KM, Cheng M, Zhao T, Hong KH, Treff NR, et al. Comprehensive chromosome screening alters traditional morphology-based embryo selection: a prospective study of 100 consecutive cycles of planned fresh euploid blastocyst transfer. Fertil Steril. 2013;100(3):718–24. doi:10.1016/j.fertnstert.2013.04.043.PubMedCrossRef Forman EJ, Upham KM, Cheng M, Zhao T, Hong KH, Treff NR, et al. Comprehensive chromosome screening alters traditional morphology-based embryo selection: a prospective study of 100 consecutive cycles of planned fresh euploid blastocyst transfer. Fertil Steril. 2013;100(3):718–24. doi:10.​1016/​j.​fertnstert.​2013.​04.​043.PubMedCrossRef
19.
Zurück zum Zitat Wong CC, Loewke KE, Bossert NL, Behr B, De Jonge CJ, Baer TM, et al. Non-invasive imaging of human embryos before embryonic genome activation predicts development to the blastocyst stage. Nat Biotechnol. 2010;28(10):1115–21. doi:10.1038/nbt.1686.PubMedCrossRef Wong CC, Loewke KE, Bossert NL, Behr B, De Jonge CJ, Baer TM, et al. Non-invasive imaging of human embryos before embryonic genome activation predicts development to the blastocyst stage. Nat Biotechnol. 2010;28(10):1115–21. doi:10.​1038/​nbt.​1686.PubMedCrossRef
20.
Zurück zum Zitat Meseguer M, Rubio I, Cruz M, Basile N, Marcos J, Requena A. Embryo incubation and selection in a time-lapse monitoring system improves pregnancy outcome compared with a standard incubator: a retrospective cohort study. Fertil Steril. 2012;98(6):1481–9 e10. doi:10.1016/j.fertnstert.2012.08.016.PubMedCrossRef Meseguer M, Rubio I, Cruz M, Basile N, Marcos J, Requena A. Embryo incubation and selection in a time-lapse monitoring system improves pregnancy outcome compared with a standard incubator: a retrospective cohort study. Fertil Steril. 2012;98(6):1481–9 e10. doi:10.​1016/​j.​fertnstert.​2012.​08.​016.PubMedCrossRef
22.
Zurück zum Zitat Dal Canto M, Coticchio G, Mignini Renzini M, De Ponti E, Novara PV, Brambillasca F, et al. Cleavage kinetics analysis of human embryos predicts development to blastocyst and implantation. Reprod Biomed Online. 2012;25(5):474–80. doi:10.1016/j.rbmo.2012.07.016.PubMedCrossRef Dal Canto M, Coticchio G, Mignini Renzini M, De Ponti E, Novara PV, Brambillasca F, et al. Cleavage kinetics analysis of human embryos predicts development to blastocyst and implantation. Reprod Biomed Online. 2012;25(5):474–80. doi:10.​1016/​j.​rbmo.​2012.​07.​016.PubMedCrossRef
27.
Zurück zum Zitat Racowsky C, Stern JE, Gibbons WE, Behr B, Pomeroy KO, Biggers JD. National collection of embryo morphology data into society for assisted reproductive technology clinic outcomes reporting system: associations among day 3 cell number, fragmentation and blastomere asymmetry, and live birth rate. Fertil Steril. 2011;95(6):1985–9. doi:10.1016/j.fertnstert.2011.02.009.PubMedCrossRef Racowsky C, Stern JE, Gibbons WE, Behr B, Pomeroy KO, Biggers JD. National collection of embryo morphology data into society for assisted reproductive technology clinic outcomes reporting system: associations among day 3 cell number, fragmentation and blastomere asymmetry, and live birth rate. Fertil Steril. 2011;95(6):1985–9. doi:10.​1016/​j.​fertnstert.​2011.​02.​009.PubMedCrossRef
28.
Zurück zum Zitat Rubin DB. Multiple Imputation for Nonresponse in Surveys. 1987. Rubin DB. Multiple Imputation for Nonresponse in Surveys. 1987.
29.
Zurück zum Zitat Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PM. The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol. 2003;56(11):1129–35.PubMedCrossRef Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PM. The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol. 2003;56(11):1129–35.PubMedCrossRef
30.
35.
Metadaten
Titel
Using the Eeva Test™ adjunctively to traditional day 3 morphology is informative for consistent embryo assessment within a panel of embryologists with diverse experience
verfasst von
Michael P. Diamond
Vaishali Suraj
Erica J. Behnke
Xinli Yang
Marlane J. Angle
Jaclyn C. Lambe-Steinmiller
Rachel Watterson
Kelly Athayde Wirka
Alice A. Chen
Shehua Shen
Publikationsdatum
01.01.2015
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 1/2015
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-014-0366-1

Weitere Artikel der Ausgabe 1/2015

Journal of Assisted Reproduction and Genetics 1/2015 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.