title: Retrospective analysis of outcomes after IVF using an aneuploidy risk model derived from time-lapse imaging without PGS.
abstract: Time-lapse imaging of human preimplantation IVF embryos has enabled objective algorithms based on novel observations of development (morphokinetics) to be used for clinical selection of embryos. Embryo aneuploidy, a major cause of IVF failure, has been correlated with specific morphokinetic variables used previously to develop an aneuploidy risk classification model. The purpose of this study was to evaluate the effectiveness and potential impact of this model for unselected IVF patients without biopsy and preimplantation genetic screening (PGS). Embryo outcomes - no implantation, fetal heart beat (FHB) and live birth (LB) - of 88 transferred blastocysts were compared according to calculated aneuploidy risk classes (low, medium, high). A significant difference was seen for FHB (P<0.0001) and LB (P<0.01) rates between embryos classified as low and medium risk. Within the low-risk class, relative increases of 74% and 56%, compared with rates for all blastocysts, were observed for FHB and LB respectively. The area under the receiver operating characteristic curve was 0.75 for FHB and 0.74 for LB. This study demonstrates the clinical relevance of the aneuploidy risk classification model and introduces a novel, non-invasive method of embryo selection to yield higher implantation and live birth rates without PGS.
authors.affiliation: CARE Fertility, John Webster House, 6 Lawrence Drive, Nottingham Business Park, Nottingham NG8 6PZ, United Kingdom. Alison.campbell@carefertility.com
authors.forename: Alison
authors.initials: A
authors.lastname: Campbell
authors.forename: Simon
authors.initials: S
authors.lastname: Fishel
authors.forename: Natalie
authors.initials: N
authors.lastname: Bowman
authors.forename: Samantha
authors.initials: S
authors.lastname: Duffy
authors.forename: Mark
authors.initials: M
authors.lastname: Sedler
authors.forename: Simon
authors.initials: S
authors.lastname: Thornton
mesh_terms: D000328:Adult; D000782:Aneuploidy; D015331:Cohort Studies; D004477:Ectogenesis; D004624:Embryo Transfer; D004739:England / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D007248:Infertility, Male; D050498:Live Birth; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D012306:Risk; D059008:Time-Lapse Imaging
keywords: IVF; aneuploidy; blastocyst; embryology; live birth; time-lapse imaging