title: Time-lapse morphokinetic assessment has low to moderate ability to predict euploidy when patient- and ovarian stimulation-related factors are taken into account with the use of clustered data analysis.
abstract: To study whether time-lapse morphokinetic (TLM) assessment predicts ploidy status when patient- and ovarian stimulation-related factors are taken into account.
  
  
  
  Retrospective cohort study.
  
  
  
  Private IVF clinic.
  
  
  
  In total, 103 consecutive patients (415 blastocysts) were included. All embryos were individually cultured in a time-lapse incubator from intracytoplasmic sperm injection up to trophectoderm biopsy. Following trophectoderm biopsy on day 5 or 6, blastocysts were vitrified and 23 TLM parameters were analyzed.
  
  
  
  Correlations between patient- and ovarian stimulation-related factors and TLM parameters were tested in a multilevel mixed-effects linear regression model and assessed by means of intraclass correlation coefficient (ICC).
  
  
  
  Predictive ability of TLM parameters for euploidy.
  
  
  
  The majority of TLM parameters had ICCs of 16%-47%. None of the patient- or ovarian stimulation-related factor had any systematic effect on any TLM parameter; however, body mass, total FSH dose, duration of infertility, number of previous cycles, antral follicle count, ovarian stimulation protocol, and E2on the trigger day had a significant impact on some TLM parameters. With the use of multilevel mixed-effects logistic regression analysis, of the ten TLM parameters that were initially noted to be significantly different among euploid and aneuploid blastocysts in the univariate analysis, only five remained significant. However, the areas under the receiver operating characteristic curves at regression analysis were low, ranging from 0.55 to 0.63.
  
  
  
  Five TLM parameters, all related to timing of blastocyst development, have limited ability to predict euploidy when patient- and ovarian stimulation-related factors are taken into account.
authors.affiliation: Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Sezcan
authors.initials: S
authors.lastname: Mumusoglu
authors.affiliation: Anatolia IVF and Women's Health Center, Ankara, Turkey.
authors.forename: Irem
authors.initials: I
authors.lastname: Yarali
authors.affiliation: Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Gurkan
authors.initials: G
authors.lastname: Bozdag
authors.affiliation: Department of Biostatistics, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Ozdemir
authors.affiliation: Anatolia IVF and Women's Health Center, Ankara, Turkey.
authors.forename: Mehtap
authors.initials: M
authors.lastname: Polat
authors.affiliation: Department of Histology and Embryology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Lale Karakoc
authors.initials: LK
authors.lastname: Sokmensuer
authors.affiliation: Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey; Anatolia IVF and Women's Health Center, Ankara, Turkey. Electronic address: hyarali@hacettepe.edu.tr.
authors.forename: Hakan
authors.initials: H
authors.lastname: Yarali
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001706:Biopsy; D001755:Blastocyst / Q000473:pathology*; D015925:Cryopreservation; D046149:Embryo Culture Techniques; D005260:Female; D005298:Fertility; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016014:Linear Models; D008297:Male; D018715:Microscopy, Video / Q000295:instrumentation; D015999:Multivariate Analysis; D010062:Ovulation Induction / Q000009:adverse effects; D011003:Ploidies; D011237:Predictive Value of Tests; D011247:Pregnancy; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects; D013997:Time Factors; D059008:Time-Lapse Imaging / Q000295:instrumentation; D058989:Vitrification
keywords: Time-lapse; aneuploidy; cluster analysis; confounding; morphokinetic parameters; preimplantation genetic testing