title: 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.
abstract: OBJECTIVE
  To evaluate the validity of collecting day 3 embryo morphology variables into the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS).
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  National database-SART CORS.
  
  
  METHODS
  Fresh autologous assisted reproductive technology (ART) cycles from 2006-2007 in which embryos were transferred singly (n=1,020) or in pairs (n=6,508) and embryo morphology was collected.
  
  
  METHODS
  None.
  
  
  METHODS
  Relationship between live birth, maternal age, and morphology of transferred day 3 embryos as defined by cell number, fragmentation, and blastomere symmetry. Logistic multiple regressions and receiver operating characteristic curve analyses were applied to determine specificity and sensitivity for correctly classifying embryos as either failures or successes.
  
  
  RESULTS
  Live birth rate was positively associated with increasing cell number up to eight cells (<6 cells: 2.9%; 6 cells: 9.6%; 7 cells: 15.5%; 8 cells: 24.3%; and >8 cells: 16.2%), but was negatively associated with maternal age, increasing fragmentation, and asymmetry scores. An area under the receiver operating curve of 0.753 (95% confidence interval 0.740-0.766) was derived, with a sensitivity of 45.0%, a specificity of 83.2%, and 76.4% of embryos being correctly classified with a cutoff probability of 0.3.
  
  
  CONCLUSIONS
  This analysis provides support for the validity of collecting morphology fields for day 3 embryos into SART CORS. Standardization of morphology collections will assist in controlling for embryo quality in future database analyses.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Biology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. cracowsky@partners.org
authors.forename: Catherine
authors.initials: C
authors.lastname: Racowsky
authors.forename: Judy E
authors.initials: JE
authors.lastname: Stern
authors.forename: William E
authors.initials: WE
authors.lastname: Gibbons
authors.forename: Barry
authors.initials: B
authors.lastname: Behr
authors.forename: Kimball O
authors.initials: KO
authors.lastname: Pomeroy
authors.forename: John D
authors.initials: JD
authors.lastname: Biggers
mesh_terms: D000328:Adult; D001757:Blastomeres / Q000166:cytology*; D002452:Cell Count; D048430:Cell Shape; D002970:Cleavage Stage, Ovum / Q000166:cytology*; D003625:Data Collection / Q000379:methods; D016208:Databases, Factual; D004622:Embryo, Mammalian / Q000166:cytology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009099:Multiple Birth Offspring / Q000706:statistics & numerical data; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D012955:Societies, Medical / Q000458:organization & administration*; D016896:Treatment Outcome; D014481:United States