Comparison of Two Embryo Scoring Systems for Prediction of Outcome in Assisted Reproductive Techniques Cycles
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Abstract
Cumulative embryo score (CES) is one of the many embryo scoring methods which have been developed to help clinicians to transfer high quality embryos and predict pregnancy rate in assisted reproductive techniques (ART) cycles. Regarding the existing difference in CES calculation this study was done to compare two methods in order to determine the more practical and preferable one. In a retrospective, cross sectional descriptive analytical study, a total of 508 ART cycles in infertile patients treated from November 2002 until March 2004, were evaluated using two methods of CES calculation in embryonic scoring to predict ART outcome. According to one method, CES was obtained by adding the individual scores of all transferred embryos. Whereas in the other reference method, CES was calculated by the sum of each embryo score multiplied by its number of blastomeres on the day of transfer. The mean score of transferred embryos (MSTE) was referred to CES divided by the total number of embryos transferred in either method. A total of 109 clinical pregnancies (pregnancy rate 21.5%) including 96 singletons, 10 twins and triplets occurred in the 508 ART cycles. The pregnancy rate was strongly correlated to CES & MSTE. According to one method, CES was 12.6±6.4 in pregnant versus 9.2±5.8 in non-pregnant group (P<0.0001). According to the other one, in the pregnant group CES was 86.7±48 versus 68.7±55 in the non-pregnant group (P<0.002). Both methods showed a significant difference. Regarding MSTE, using the first method, in the pregnant group it was 3±0.6 versus 2.8±0.7 in the non-pregnant group (P<0.011) whereas with the other approach it was 21.3±8.6 in the pregnant group versus 19.9±9.07 in non-pregnant (P<0.152) showing that the first method can also predict pregnancy outcome with MSTE. Considering that both MSTE and CES in the first method can significantly predict outcome in ART cycles, it seems this method is preferable and more useful in practice. Moreover, sometimes due to continuous division, on the third post oocyte retrieval day the
blastomere number cannot be counted precisely which can be misleading if taken into account according to the method introduced by Steer.
Ludwig M. Complications in ART treatment. In: Brinsden PR, editor. Textbook of In Vitro Fertilisation and Assisted Reproduction: The Bourne Hall Guide to Clinical and Laboratory Practice. 3rd ed. London: Taylor and Francis; 2005. p. 489-500.
Wright VC, Chang J, Jeng G, Macaluso M. Assistedreproductive technology surveillance: United States, 2003. MMWR Surveill Summ 2006;55(4):1-22.
Beral V, Doyle P, Tan SL, Mason BA, Campbell S. Outcome of pregnancies resulting from assisted conception. Br Med Bull 1990;46(3):753-68.
Steer CV, Mills CL, Tan SL, Campbell S, Edwards RG.The cumulative embryo score: a predictive embryo scoring technique to select the optimal number of embryos to transfer in an in-vitro fertilization and embryo transfer programme. Hum Reprod 1992;7(1):117-9.
Qian YL, Ye YH, Xu CM, Jin F, Huang HF. Accuracy of a combined score of zygote and embryo morphology for selecting the best embryos for IVF. J Zhejiang Univ Sci B 2008;9(8):649-55.
Loi K, Prasath EB, Huang ZW, Loh SF, Loh SK. A cumulative embryo scoring system for the prediction of pregnancy outcome following intracytoplasmic sperminjection. Singapore Med J 2008;49(3):221-7.
Staessen C, Camus M, Bollen N, Devroey P, Van Steirteghem AC. The relationship between embryo quality and the occurrence of multiple pregnancies. Fertil Steril 1992;57(3):626-30.
Ziebe S, Petersen K, Lindenberg S, Andersen AG, Gabrielsen A, Andersen AN. Embryo morphology or cleavage stage: how to select the best embryos for transfer after in-vitro fertilization. Hum Reprod 1997;12(7):1545-9.
Saith RR, Srinivasan A, Michie D, Sargent IL. Relationships between the developmental potential of human in-vitro fertilization embryos and features describing the embryo, oocyte and follicle. Hum Reprod Update 1998;4(2):121-34.
Sakkas D, Shoukir Y, Chardonnens D, Bianchi PG, Campana A. Early cleavage of human embryos to the twocell stage after intracytoplasmic sperm injection as an indicator of embryo viability. Hum Reprod 1998;13(1):182-7.
Van Montfoort AP, Dumoulin JC, Kester AD, Evers JL. Early cleavage is a valuable addition to existing embryo selection parameters: a study using single embryotransfers. Hum Reprod 2004;19(9):2103-8.
Montag M, van der Ven H; German Pronuclear Morphology Study Group. Evaluation of pronuclear morphology as the only selection criterion for further embryo culture and transfer: results of a prospective multicentre study. Hum Reprod 2001;16(11):2384-9.
De Placido G, Wilding M, Strina I, Alviggi E, Alviggi C, Mollo A, Varicchio MT, Tolino A, Schiattarella C, Dale B. High outcome predictability after IVF using a combinedscore for zygote and embryo morphology and growth rate. Hum Reprod 2002;17(9):2402-9.
Cummins JM, Breen TM, Harrison KL, Shaw JM, Wilson LM, Hennessey JF. A formula for scoring human embryo growth rates in in vitro fertilization: its value in predicting pregnancy and in comparison with visual estimates ofembryo quality. J In Vitro Fert Embryo Transf 1986;3(5):284-95.
Puissant F, Van Rysselberge M, Barlow P, Deweze J, Leroy F. Embryo scoring as a prognostic tool in IVF treatment. Hum Reprod 1987;2(8):705-8.
Visser DS, Fourie FR. The applicability of the cumulativeembryo score system for embryo selection and qualitycontrol in an in-vitro fertilization/embryo transferprogramme. Hum Reprod 1993;8(10):1719-22.
Roseboom TJ, Vermeiden JP, Schoute E, Lens JW, Schats R. The probability of pregnancy after embryo transfer is affected by the age of the patient, cause of infertility, number of embryos transferred and the average morphology score, as revealed by multiple logistic regression analysis. Hum Reprod 1995;10(11):3035-41.
Terriou P, Sapin C, Giorgetti C, Hans E, Spach JL, RoulierR. Embryo score is a better predictor of pregnancy than the number of transferred embryos or female age. Fertil Steril2001;75(3):525-31.
Lambers MJ, Mager E, Goutbeek J, McDonnell J, Homburg R, Schats R, Hompes PG, Lambalk CB. Factors determining early pregnancy loss in singleton and multiple implantations. Hum Reprod 2007;22(1):275-9.
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| Issue | Vol 49, No 12 (2011) | |
| Section | Articles | |
| Keywords | ||
| Cumulative embryo score Mean Score of Transferred Embryos Assisted Reproductive techniques | ||
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