title: Diagnosis of human preimplantation embryo viability.
abstract: BACKGROUND
  Transfer of more than a single embryo in an IVF cycle comes with the finite possibility of a multiple gestation. Even a twin pregnancy confers significant risk to both mother and babies. The move to single-embryo transfer for all patients will be greatly facilitated by the ability to quantify embryo viability. Developments in time-lapse incubation systems have provided new insights into the developmental kinetics of the human preimplantation embryo. Advances in molecular methods of chromosomal analysis have created platforms for highly effective screening of biopsied embryos, while noninvasive analysis of embryo physiology reveals more about the embryo than can be determined by morphology alone.
  
  
  METHODS
  Recent developments in time-lapse microscopy, molecular karyotyping and in proteomics and metabolomics have been assessed and presented here in a descriptive review.
  
  
  CONCLUSIONS
  New algorithms are being created for embryo selection based on their developmental kinetics in culture, and the impact of factors such as patient etiology and treatment are being clarified. Potential links between morphokinetic data and embryo karyotype are being elucidated. The introduction of new molecular methods of determining embryo chromosomal complement is proving to be accurate and reproducible, with the future trending toward CGH arrays or next generation sequencing as a rapid and reliable means of analysis, that should be suitable for each IVF clinic to adopt. A relationship between embryo metabolism and viability is established and is now being considered together with morphokinetic data to create more robust algorithms for embryo selection. Microfluidic devices have the capacity and potential to be used in human IVF clinics for the routine diagnosis of embryo biomarkers.
authors.affiliation: School of BioSciences, University of Melbourne, Parkville, VIC 3010, Australia david.gardner@unimelb.edu.au.
authors.forename: David K
authors.initials: DK
authors.lastname: Gardner
authors.affiliation: Laboratorio Fiv, IVI Valencia, Plaza Policía Local, 3, Valencia 46015, Spain.
authors.forename: Marcos
authors.initials: M
authors.lastname: Meseguer
authors.affiliation: IGENOMIX and Fundación Instituto Valenciano de Infertilidad (FIVI)/INCLIVA, Valencia, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Rubio
authors.affiliation: Reproductive Medicine Associates of New Jersey, Basking Ridge, NJ 07960, USA.
authors.forename: Nathan R
authors.initials: NR
authors.lastname: Treff
mesh_terms: D000465:Algorithms; D015415:Biomarkers / Q000378:metabolism; D001755:Blastocyst / Q000166:cytology* / Q000502:physiology; D002455:Cell Division; D046149:Embryo Culture Techniques; D004624:Embryo Transfer; D047108:Embryonic Development / Q000502:physiology*; D059014:High-Throughput Nucleotide Sequencing; D006801:Humans; D007621:Karyotyping; D056656:Lab-On-A-Chip Devices; D019836:Preimplantation Diagnosis / Q000379:methods*; D059008:Time-Lapse Imaging
chemical_list: D015415:Biomarkers
keywords: chromosome; embryo viability; metabolism; selection; time lapse