title: Automatic time-lapse instrument is superior to single-point morphology observation for selecting viable embryos: retrospective study in oocyte donation.
abstract: OBJECTIVE
  To correlate the different categories provided by a commercial diagnostic test with blastocyst formation, quality, implantation potential, and ongoing pregnancy (OPR) for the purpose of validating the automatic annotations and the classification algorithm.
  
  
  METHODS
  Observational, retrospective, multicenter cohort study.
  
  
  METHODS
  University-affiliated private IVF center.
  
  
  METHODS
  A total of 3,002 embryos, including 521 transferred embryos with known implantation, from 626 IVF cycles that were incubated in a conventional incubator and monitored with an automatic time-lapse test.
  
  
  METHODS
  None.
  
  
  METHODS
  Embryo selection was based on morphology and the classification provided by a commercial diagnostic test. Implantation was the primary end point, and OPR, blastocyst formation (BR), and embryo morphology were secondary end points.
  
  
  RESULTS
  BR and number of optimal blastocysts were related to the classification test. This correlation was also observed when analyzing implantation rates (day 3 transfer: high 38.2%, medium 31.7% and low 26.1%; day 5 transfer: high 66.7%, medium 50%, low 31%). Patients where no high embryos were transferred (n = 75) had an OPR of 46.70%, and those patients where at least one high embryo was transferred (n = 109) significantly increased OPR to 67%. A logistic regression analysis studying other confounding factors (day of transfer, number of oocytes obtained, and embryo morphology classification) was included. In that model, if at least one of the embryos was labeled as high, OPR was 2.567 times higher than a cycle where no high embryos were transferred.
  
  
  CONCLUSIONS
  Our study presents, to our knowledge, the largest set of transferred embryos after time-lapse analysis with the use of an automatic time-lapse test. The provided classification was related to reproductive outcome. Our results suggest that the automated embryo diagnostic test provided extra information to the embryologist to select the best embryos, independently from clinical features of the patient or day of transfer.
authors.affiliation: Instituto Valenciano de Infertilidad (IVI) Valencia, INCLIVA-Universidad de Valencia, Valencia, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Aparicio-Ruiz
authors.affiliation: IVI Madrid, Madrid, Spain.
authors.forename: Natalia
authors.initials: N
authors.lastname: Basile
authors.affiliation: Instituto Valenciano de Infertilidad (IVI) Valencia, INCLIVA-Universidad de Valencia, Valencia, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Pérez Albalá
authors.affiliation: IVI Madrid, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Bronet
authors.affiliation: Instituto Valenciano de Infertilidad (IVI) Valencia, INCLIVA-Universidad de Valencia, Valencia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Remohí
authors.affiliation: Instituto Valenciano de Infertilidad (IVI) Valencia, INCLIVA-Universidad de Valencia, Valencia, Spain. Electronic address: marcos.meseguer@ivi.es.
authors.forename: Marcos
authors.initials: M
authors.lastname: Meseguer
mesh_terms: D001331:Automation; D001755:Blastocyst / Q000166:cytology*; D002470:Cell Survival; D046149:Embryo Culture Techniques; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005298:Fertility; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D007700:Kinetics; D018587:Oocyte Donation / Q000009:adverse effects; D054315:Oocyte Retrieval; D010062:Ovulation Induction; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012984:Software; D013030:Spain; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects; D059008:Time-Lapse Imaging; D016896:Treatment Outcome
keywords: Embryo; automatic; implantation; morphokinetics; pregnancy; time lapse