Ashleigh Storr1, Christos Venetis2, Simon Cooke2, Suha Kilani2, William Ledger2. 1. IVF Australia, Sydney; and School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia. Electronic address: ashleigh.storr@outlook.com. 2. IVF Australia, Sydney; and School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia.
Abstract
OBJECTIVE: To determine the agreement between published time-lapse algorithms in selecting the best day-5 embryo for transfer, as well as the agreement between these algorithms and embryologists. DESIGN: Prospective study. SETTING: Private in vitro fertilization center. PATIENT(S): Four hundred and twenty-eight embryos from 100 cycles cultured in the EmbryoScope. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Interalgorithm agreement as assessed by the Fleiss kappa coefficient. RESULT(S): Of seven published algorithms analyzed in this study, only one of the 18 possible pairs showed very good agreement (κ = 0.867); one pair showed good agreement (κ = 0.725), four pairs showed fair agreement (κ = 0.226-0.334), and the remaining 12 pairs showed poor agreement (κ = 0.008-0.149). Even in the best-case scenario, the majority of algorithms showed poor to moderate kappa scores (κ = 0.337-0.722) for the assessment of agreement between the embryo(s) selected as "best" by the algorithms and the embryo that was chosen by the majority (>5) of embryologists, as well as with the embryo that was actually selected in the laboratory on the day of transfer (κ = 0.315-0.802). CONCLUSION(S): The results of this study raise concerns as to whether the tested algorithms are applicable in different clinical settings, emphasizing the need for proper external validation before clinical use.
OBJECTIVE: To determine the agreement between published time-lapse algorithms in selecting the best day-5 embryo for transfer, as well as the agreement between these algorithms and embryologists. DESIGN: Prospective study. SETTING: Private in vitro fertilization center. PATIENT(S): Four hundred and twenty-eight embryos from 100 cycles cultured in the EmbryoScope. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Interalgorithm agreement as assessed by the Fleiss kappa coefficient. RESULT(S): Of seven published algorithms analyzed in this study, only one of the 18 possible pairs showed very good agreement (κ = 0.867); one pair showed good agreement (κ = 0.725), four pairs showed fair agreement (κ = 0.226-0.334), and the remaining 12 pairs showed poor agreement (κ = 0.008-0.149). Even in the best-case scenario, the majority of algorithms showed poor to moderate kappa scores (κ = 0.337-0.722) for the assessment of agreement between the embryo(s) selected as "best" by the algorithms and the embryo that was chosen by the majority (>5) of embryologists, as well as with the embryo that was actually selected in the laboratory on the day of transfer (κ = 0.315-0.802). CONCLUSION(S): The results of this study raise concerns as to whether the tested algorithms are applicable in different clinical settings, emphasizing the need for proper external validation before clinical use.
Authors: Susanna Apter; Thomas Ebner; Thomas Freour; Yves Guns; Borut Kovacic; Nathalie Le Clef; Monica Marques; Marcos Meseguer; Debbie Montjean; Ioannis Sfontouris; Roger Sturmey; Giovanni Coticchio Journal: Hum Reprod Open Date: 2020-03-19