Giovanni Coticchio1, Barry Behr2, Alison Campbell3, Marcos Meseguer4, Dean E Morbeck5,6, Valerio Pisaturo7, Carlos E Plancha8, Denny Sakkas9,10, Yanwen Xu11, Thomas D'Hooghe10,12,13, Evelyn Cottell12, Kersti Lundin14. 1. 9.baby Family and Fertility Center, Via Dante, 15, 40125, Bologna, Italy. giovanni.coticchio@nove.baby. 2. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA, USA. 3. CARE Fertility Group, John Webster House, Nottingham, UK. 4. IVI-RMA Global, Valencia, Spain. 5. Fertility Associates, Auckland, New Zealand. 6. Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. 7. Reproductive Medicine Department, International Evangelical Hospital, Genoa, Italy. 8. Inst. Histologia e Biologia do Desenvolvimento, Faculdade de Medicina, Universidade de Lisboa and CEMEARE, Lisbon, Portugal. 9. Boston IVF, Waltham, MA, USA. 10. Department of Obstetrics and Gynecology, Yale University, New Haven, CT, USA. 11. Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China. 12. Global Medical Affairs Fertility, R&D Biopharma, Merck KGaA, Darmstadt, Germany. 13. Department of Development and Regeneration, Biomedical Sciences Group, KU Leuven (University of Leuven), Leuven, Belgium. 14. Reproductive Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Abstract
PURPOSE: To explore how the assisted reproductive technology (ART) laboratories can be optimized and standardized to enhance embryo culture and selection, to bridge the gap between standard practice and the new concept of shortening time to healthy singleton birth. METHODS: A Delphi consensus was conducted (January to July 2018) to assess how the ART laboratory could be optimized, in conjunction with existing guidelines, to reduce the time to a healthy singleton birth. Eight experts plus the coordinator discussed and refined statements proposed by the coordinator. The statements were distributed via an online survey to 29 participants (including the eight experts from step 1), who voted on their agreement/disagreement with each statement. Consensus was reached if ≥ 66% of participants agreed/disagreed with a statement. If consensus was not achieved for any statement, that statement was revised and the process repeated until consensus was achieved. Details of statements achieving consensus were communicated to the participants. RESULTS: Consensus was achieved for all 13 statements, which underlined the need for professional guidelines and standardization of lab processes to increase laboratory competency and quality. The most important points identified were the improvement of embryo culture and embryo assessment to shorten time to live birth through the availability of more high-quality embryos, priority selection of the most viable embryos and improved cryosurvival. CONCLUSION: The efficiency of the ART laboratory can be improved through professional guidelines on standardized practices and optimized embryo culture environment, assessment, selection and cryopreservation methodologies, thereby reducing the time to a healthy singleton delivery.
PURPOSE: To explore how the assisted reproductive technology (ART) laboratories can be optimized and standardized to enhance embryo culture and selection, to bridge the gap between standard practice and the new concept of shortening time to healthy singleton birth. METHODS: A Delphi consensus was conducted (January to July 2018) to assess how the ART laboratory could be optimized, in conjunction with existing guidelines, to reduce the time to a healthy singleton birth. Eight experts plus the coordinator discussed and refined statements proposed by the coordinator. The statements were distributed via an online survey to 29 participants (including the eight experts from step 1), who voted on their agreement/disagreement with each statement. Consensus was reached if ≥ 66% of participants agreed/disagreed with a statement. If consensus was not achieved for any statement, that statement was revised and the process repeated until consensus was achieved. Details of statements achieving consensus were communicated to the participants. RESULTS: Consensus was achieved for all 13 statements, which underlined the need for professional guidelines and standardization of lab processes to increase laboratory competency and quality. The most important points identified were the improvement of embryo culture and embryo assessment to shorten time to live birth through the availability of more high-quality embryos, priority selection of the most viable embryos and improved cryosurvival. CONCLUSION: The efficiency of the ART laboratory can be improved through professional guidelines on standardized practices and optimized embryo culture environment, assessment, selection and cryopreservation methodologies, thereby reducing the time to a healthy singleton delivery.
Entities:
Keywords:
ART laboratory; Consensus; Expert opinion; Process optimization; Time to live birth
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