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- Adolfsson, Emma, 1977-, et al.
(författare)
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External validation of a time-lapse model : a retrospective study comparing embryo evaluation using a morphokinetic model to standard morphology with live birth as endpoint
- 2018
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Ingår i: Jornal Brasileiro de Reproducao Assistida. - : GN1 Genesis Network. - 1517-5693 .- 1518-0557. ; 22:3, s. 205-214
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To validate a morphokinetic implantation model developed for EmbryoScope on embryos with known outcome, compared to standard morphology in a retrospective single center study.METHODS: Morphokinetic annotation of 768 embryos with known outcome between 2013 -2015; corresponding to 116 D3 fresh embryos, 80 D6 frozen blastocysts, and 572 D5 blastocysts, fresh or frozen. The embryos were ranked by the KIDScore into five classes, KID1-5, and grouped into four classes based on standard morphology. Pregnancy rates, clinical pregnancy rates and live birth rates were compared. Combinations of morphology and morphokinetics were evaluated for implantation rates and live births.RESULTS: Live birth rate increased with increasing KIDScore, from 19% for KID1 to 42% for KID5. Of all live births, KID5 contributed with 71%, KID4 with 20%, KID3 with 4%, KID2 with 4%, and KID1 with 2%. For morphology, the corresponding figure was 43% for Top Quality, 47% for Good Quality, 4% for Poor Quality, and 5% for Slow embryos. For day 3 embryos, KID5 embryos had the highest live birth rates, and contributed to 83% of the live births; whereas the second best morphological class had the highest live birth rate and contributed to most of the live births. For blastocysts, the KIDScore and morphology performed equally well. Combining morphology and morphokinetics indicated stronger predictive power for morphokinetics.CONCLUSIONS: Overall, the KIDScore correlates with both implantation and live birth in our clinical setting. Compared to morphology, the KIDScore was superior for day 3 embryos, and equally good for blastocysts at predicting live births.
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| 2. |
- Adolfsson, Emma, 1977-, et al.
(författare)
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Morphology vs morphokinetics : a retrospective comparison of inter-observer and intra-observer agreement between embryologists on blastocysts with known implantation outcome
- 2018
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Ingår i: Jornal Brasileiro de Reproducao Assistida. - : GN1 Genesis Network. - 1517-5693 .- 1518-0557. ; 22:3, s. 228-237
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Our primary aim was to compare the morphology and morphokinetics on inter- and intra-observer agreement for blastocyst with known implantation outcome. Our secondary aim was to validate the morphokinetic parameters' ability to predict pregnancy using a previous published selection algorithm, and to compare this to standard morphology assessments.METHODS: Two embryologists made independent blinded annotations on two occasions using time-lapse images and morphology evaluations using the Gardner Schoolcraft criteria of 99 blastocysts with known implantation outcome. Inter- and intra-observer agreement was calculated and compared using the two methods. The embryos were grouped based on their morphological score, and on their morphokinetic class using a previous published selection algorithm. The implantation rates for each group was calculated and compared.RESULTS: There was moderate agreement for morphology, with agreement on the same embryo score in 55 of 99 cases. The highest agreement rate was found for expansion grade, followed by trophectoderm and inner cell mass. Correlation with pregnancy was inconclusive. For morphokinetics, almost perfect agreement was found for early and late embryo development events, and strong agreement for day-2 and day-3 events. When applying the selection algorithm, the embryo distributions were uneven, and correlation to pregnancy was inconclusive.CONCLUSIONS: Time-lapse annotation is consistent and accurate, but our external validation of a previously published selection algorithm was unsuccessful.
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| 3. |
- Castellón, L. A. R., et al.
(författare)
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The history behind successful uterine transplantation in humans
- 2017
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Ingår i: Jornal Brasileiro de Reproducao Assistida. - : GN1 Genesis Network. - 1517-5693. ; 21:2, s. 126-134
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Tidskriftsartikel (refereegranskat)abstract
- This paper aimed to describe the basic aspects of uterine transplant (UTx) research in humans, including preliminary experiences in rodents and domestic species. Studies in rats, domestic species, and non-human primates validated and optimized the UTx procedure in terms of its surgical aspects, immunosuppression, rejection diagnosis, peculiarities of pregnancy in immunosuppressed patients, and patients with special uterine conditions. In animal species, the first live birth from UTx was achieved in a syngeneic mouse model in 2003. Twenty-five UTx procedures have been performed in humans. The first two cases were unsuccessful, but established the need for rigorous research to improve success rates. As a result of a controlled clinical study under a strictly designed research protocol, nine subsequent UTx procedures have resulted in six healthy live births, the first of them in 2014. Further failed UTx procedures have been performed in China, Czech Republic, Brazil, Germany, and the United States, most of which using living donors. Albeit still an experimental procedure in, UTx is the first potential alternative for the treatment of absolute uterine factor infertility (AUFI). © 2017, Sociedade Brasileira de Reproducao Assistida. All rights reserved.
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