A New Algorithm for Embryo Selection?

Peter Kovacs, MD, PhD


November 01, 2016


TL morphokinetic information was obtained for 3275 embryos with known implantation data (embryos that were actually implanted vs not implanted) from 24 clinics. Patients younger than 40 years who had day 3 transfers were included. All cycles were managed according to the clinic's local protocol; therefore, stimulation and culture characteristics differed.

A decision-tree algorithm was built on the basis of five kinetic events (up to the eight-cell stage) and one morphologic event. Five scores (KIDScore) were assigned to the embryos on the basis of morphokinetic parameters being in or out of range, and below or above cutoff thresholds.

Across the five score groups, the implantation rate increased sevenfold, from 5.18% (score 1) to 36.17% (score 5). The algorithm was tested in subsets of cycles based on IVF vs intracytoplasmic sperm injection (ICSI) fertilization and low vs atmospheric oxygen concentration; very similar outcomes were obtained compared with the results based on the entire data set. This suggests that the algorithm works well in both low and ambient oxygen concentration and with both IVF and ICSI fertilization.

The authors concluded that this algorithm could be universally accepted, because it works well under different conditions and is therefore ready for clinical use.


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