title: Metabolomic profiling by near-infrared spectroscopy as a tool to assess embryo viability: a novel, non-invasive method for embryo selection.
abstract: BACKGROUND
  The morphology of an embryo has a limited predictive value for assessing viability and ongoing pregnancy, therefore new selection tools are needed to maintain success rates with single-embryo transfer (SET). In this study, we investigated if metabolomic profiling of biomarkers of embryo culture medium by near-infrared (NIR) spectroscopy has a correlation with ongoing pregnancy in SET.
  
  
  METHODS
  A total of 333 patients scheduled for in vitro fertilization (IVF) with SET were included in the study. Embryos were selected for transfer by morphological criteria on Days 2 and 3 of in vitro culture, and left over culture media samples were analyzed by NIR spectroscopy.
  
  
  RESULTS
  The NIR spectral analysis produced unique metabolomic profiles that correlated to an embryo's reproductive potential. Resulting relative viability scores between positive and negative pregnancy outcomes were statistically significant (P < 0.03). A logistic regression of factors correlated to pregnancy outcomes showed that maternal age, percent fragmentation and relative viability scores all demonstrated a relationship. The extent of the correlation was determined by accuracy computation, where the accuracy of assessing viable embryos on Day 3 by metabolomic profiling was 53.6% and the accuracy of the morphological selection was 38.5%. In addition, the positive predictive value of metabolomic profiling was 0.365 and the negative predictive value was 0.830.
  
  
  CONCLUSIONS
  NIR metabolomic profiling of spent embryo culture media was able to distinguish viable embryos from non-viable embryos for reproduction.
authors.affiliation: Department of Obstetrics, Gynaecology and Reproductive Medicine, VU University Medical Center, Amsterdam, The Netherlands. carlijn.vergouw@vumc.nl
authors.forename: C G
authors.initials: CG
authors.lastname: Vergouw
authors.forename: L L
authors.initials: LL
authors.lastname: Botros
authors.forename: P
authors.initials: P
authors.lastname: Roos
authors.forename: J W
authors.initials: JW
authors.lastname: Lens
authors.forename: R
authors.initials: R
authors.lastname: Schats
authors.forename: P G A
authors.initials: PG
authors.lastname: Hompes
authors.forename: D H
authors.initials: DH
authors.lastname: Burns
authors.forename: C B
authors.initials: CB
authors.lastname: Lambalk
mesh_terms: D000328:Adult; D001671:Biochemistry / Q000379:methods*; D015415:Biomarkers / Q000032:analysis*; D019295:Computational Biology / Q000379:methods*; D003470:Culture Media / Q000737:chemistry; D046149:Embryo Culture Techniques; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D005328:Fetal Viability; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
chemical_list: D015415:Biomarkers; D003470:Culture Media