STUDY QUESTION
Can a deep learning model predict the probability of pregnancy with fetal heart (FH) from time-lapse videos?

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Deep learning as a predictive tool for fetal heart pregnancy following time-lapse incubation and blastocyst transfer

STUDY QUESTION
Can a generally applicable morphokinetic algorithm suitable for Day 3 transfers of time-lapse monitored embryos originating from different culture conditions and fertilization methods be developed for the purpose of supporting the embryologist's decision on which embryo to transfer back to the patient in assisted reproduction?

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Development of a generally applicable morphokinetic algorithm capable of predicting the implantation potential of embryos transferred on Day 3

With the worldwide move towards single embryo transfer there has been a renewed focus on the requirement for reliable means of assessing embryo viability. In an era of 'OMICS' technologies, and algorithms created through the use of time-lapse microscopy, the actual appearance of the human embryo as it progresses through each successive developmental stage to the blastocyst appears to have been somewhat neglected in recent years. Here we review the key features of the human preimplantation embryo and consider the relationship between morphological characteristics and developmental potential. Further, the impact of the culture environment on morphological traits, how key morphological qualities reflect aspects of embryo physiology, and how computer-assisted analysis of embryo morphology may facilitate a more quantitative approach to selection are discussed. The clinical introduction of time-lapse systems has reopened our eyes and given us a new vantage point from which to view the beauty of the initial stages of human life. Rather than a future in which the morphology of the embryo is deemed irrelevant, we propose that key features, such as multinucleation, cell size and blastocyst differentiation should be included in future iterations of selection/deselection algorithms.

Assessment of human embryo development using morphological criteria in an era of time-lapse, algorithms and 'OMICS': is looking good still important?

Proof of concept: preimplantation genetic screening without embryo biopsy through analysis of cell-free DNA in spent embryo culture media

Delayed blastulation, multinucleation, and expansion grade are independently associated with live-birth rates in frozen blastocyst transfer cycles

Morphokinetic analysis and embryonic prediction for blastocyst formation through an integrated time-lapse system.

Details Session title: Embryology Session type: Poster viewing Presentation number: P-180  The effect of high humidity culture conditions over embryo development: a continuous embryo monitoring assessment Abstract title: , C. Albert , N. González , J. Marcos , L. Alegre , B. Aparicio , M. Meseguer . IVI Valencia, IVF Lab, Valencia, Spain. IVI Bilbao, IVF lab, Leioa, Spain. J.M. DE LOS SANTOS MOLINA Study question: 1 1 2 2 1 1 1 1 2 Since in vivo culture, culture conditions are humid. Our aim was to know how high humidity might affect embryo development comparing to dry conditions by using single step culture media in a continiuous embryo monitoring incubator (CEM) Our results suggested that culture conditions with high humidity atmosphere did not affect embryo development but increase the pregnancy and implantation rate Oil overlay has supported successful use of a dry incubator for culture human embryos, preventing changes in the pH, temperature. However, dry conditions may affect the osmolality due to the evaporation of culture media. Therefore, the use of humid conditions avoid osmolality changes. In a previous study we found statistical differences in terms of blastocyst rate. Pregnancy and implantation rate was affected but remained not significantly. A total of 7544 embryos from 1043 patients, from ovum donation programme and own oocytes and that were culture on a time lapse incubator system (Geri genea biomedix, Australia) were included in a retrospective and multicentric study (three IVF units and 5 CEM incubators) from 2016 to 2018 This CEM incubator has 6 separated small incubators. Three of them works in a dry atmosphere (DC) and the other 3 in humid conditions (HC). In the dry chambers, the embryos from 478 patients were cultured and under HC a total of 558. Retrospectively, blastocyst, good morphology blastocyst rate, pregnancy, implantation and miscarriage rate were evaluated. In a previous study we found that culture conditions with high humidity atmosphere promoted embryo development and reproductive outcome. This time, with increased sample size, we didn ́t found any differences in embryo development. By performing an stratified analysis, humid conditions were equaly distributed by clinic and treatment (mulivariable analisis). We had very similar blastocyst rate when the embryos were culture under high HC; 71.3% vs 71.0% DC). Also the proportion of blastocyst with good morphology was very similar 38.1 % in HC vs 37.7 % and DC. The ongoing pregnancy rate (OPR) was higher in HC vs DC (52.5 % vs 47.7% respectively), additionally the implantation rate slightly better in HC 54.85 vs 52.7 but but remained not significant. The retrospective nature of the study may limit the conclusion although sample size is remarcable. A prospective reandomize study may solve the remaining questions surrounded this topic. Our results would suggest that HC may increase the reproductive outcome of our patients when using single step media in CEM incubators although effects are limited and still need to be confirmed with a Summary answer: What is known already: Study design, size, duration: Participants/materials, setting, methods: Main results and the role of chance: Limitations, reasons for caution: Wider implications of the findings: larger sample and improved designs. NA

Belén Aparicio Ruiz

Papers

Morphokinetic analysis and embryonic prediction for blastocyst formation through an integrated time-lapse system.

The effect of high humidity culture conditions over embryo development: a continuous embryo monitoring assessment