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Fertil Steril. 2018 Feb;109(2):276-283.e3. doi: 10.1016/j.fertnstert.2017.10.036. Epub 2018 Jan 11.

Time-lapse algorithms and morphological selection of day-5 embryos for transfer: a preclinical validation study.

Author information

1
IVF Australia, Sydney; and School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia. Electronic address: ashleigh.storr@outlook.com.
2
IVF Australia, Sydney; and School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia.

Abstract

OBJECTIVE:

To determine the agreement between published time-lapse algorithms in selecting the best day-5 embryo for transfer, as well as the agreement between these algorithms and embryologists.

DESIGN:

Prospective study.

SETTING:

Private in vitro fertilization center.

PATIENT(S):

Four hundred and twenty-eight embryos from 100 cycles cultured in the EmbryoScope.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Interalgorithm agreement as assessed by the Fleiss kappa coefficient.

RESULT(S):

Of seven published algorithms analyzed in this study, only one of the 18 possible pairs showed very good agreement (κ = 0.867); one pair showed good agreement (κ = 0.725), four pairs showed fair agreement (κ = 0.226-0.334), and the remaining 12 pairs showed poor agreement (κ = 0.008-0.149). Even in the best-case scenario, the majority of algorithms showed poor to moderate kappa scores (κ = 0.337-0.722) for the assessment of agreement between the embryo(s) selected as "best" by the algorithms and the embryo that was chosen by the majority (>5) of embryologists, as well as with the embryo that was actually selected in the laboratory on the day of transfer (κ = 0.315-0.802).

CONCLUSION(S):

The results of this study raise concerns as to whether the tested algorithms are applicable in different clinical settings, emphasizing the need for proper external validation before clinical use.

KEYWORDS:

Agreement; algorithm; embryologist; morphokinetics; time-lapse

[Indexed for MEDLINE]

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