Leuven University Fertility Centre, UZ Gasthuisberg, Campus Gasthuisberg, Herestraat 49, Leuven, Belgium.
Reprod Biomed Online. 2011 Sep;23(3):347-54. doi: 10.1016/j.rbmo.2011.05.007. Epub 2011 May 19.
Embryo selection is based on embryo developmental and morphological characteristics. Standard embryo evaluation has some disadvantages. New technology using multilevel images combined with a computer-assisted scoring system (CASS) has the potential to overcome these disadvantages. The aim of this study was to compare the value of a computer-assisted scoring system (CASS) versus a standard scoring system (SSS) in predicting implantation and live birth. This prospective study included 3185 embryos obtained during 502IVF/intracytoplasmic sperm injection cycles with single-embryo transfer on day 3. Embryos were evaluated with two scoring systems: SSS and CASS. Logistic regression analyses were performed using implantation and live birth as outcomes. According to multiple regression analysis, implantation was influenced by number and size of blastomeres on day 3 using CASS and by all embryo parameters on day 3 using SSS. Combined analysis of both scoring systems revealed that implantation was affected by number and size of blastomeres using CASS and by the degree of embryo fragmentation using SSS. Using live birth as outcome, only the number of blastomeres on day 3, evaluated by SSS and CASS, was predictive. Prediction of implantation and live birth may be superior using CASS when compared with SSS. Embryo selection is currently based on embryo developmental and morphological characteristics of an embryo using a standard scoring system. This evaluation system is limited by a number of disadvantages. New technology using multilevel images combined with a computer-assisted scoring system has the potential to overcome these disadvantages. The aim of this study was to compare the value of such computer-assisted scoring system versus a standard scoring system in predicting implantation and live birth rate. This study included 3185 embryos obtained during 502 IVF or intracytoplasmic sperm injection cycles with single-embryo transfer on day 3. All the embryos were evaluated with two types of scoring systems: a standard scoring system and a computer-assisted scoring system. According to the statistical analysis, the implantation of an embryo was influenced by the number and size of blastomeres on day 3 when evaluated with the computer-assisted scoring system, and by all embryo parameters on day 3 using the standard scoring system. Combined analysis of both scoring systems revealed that implantation was affected by number and size of blastomeres using the computer-assisted scoring system and by the degree of embryo fragmentation using the standard scoring system. Live birth was influenced by the number of blastomeres on day 3 evaluated by both scoring systems. Prediction of embryo implantation and live birth was superior using the computer-assisted scoring system. In conclusion, a computer-assisted scoring system may be superior to a standard scoring system in the prediction of implantation and live birth.
胚胎选择基于胚胎的发育和形态特征。标准胚胎评估有一些缺点。使用多层次图像结合计算机辅助评分系统（CASS）的新技术有可能克服这些缺点。本研究的目的是比较计算机辅助评分系统（CASS）与标准评分系统（SSS）在预测胚胎着床和活产方面的价值。这项前瞻性研究包括 502 个体外受精/胞浆内单精子注射周期中获得的 3185 个胚胎，在第 3 天进行单个胚胎移植。胚胎采用两种评分系统进行评估：SSS 和 CASS。使用植入和活产作为结果进行逻辑回归分析。根据多元回归分析，使用 CASS 时，胚胎着床受第 3 天的卵裂球数量和大小影响，使用 SSS 时，胚胎着床受第 3 天的所有胚胎参数影响。对两种评分系统进行联合分析表明，使用 CASS 时，胚胎着床受卵裂球数量和大小影响，使用 SSS 时，胚胎碎片程度受影响。使用活产作为结果，只有第 3 天的卵裂球数量，使用 SSS 和 CASS 评估，是可预测的。与 SSS 相比，使用 CASS 预测胚胎着床和活产可能更好。目前，胚胎选择是基于胚胎的发育和形态特征，使用标准评分系统。该评估系统受到许多缺点的限制。使用多层次图像结合计算机辅助评分系统的新技术有可能克服这些缺点。本研究的目的是比较这种计算机辅助评分系统与标准评分系统在预测胚胎着床率和活产率方面的价值。本研究包括 3185 个胚胎，这些胚胎是在 502 个体外受精或胞浆内单精子注射周期中获得的，在第 3 天进行单个胚胎移植。所有胚胎均采用两种评分系统进行评估：标准评分系统和计算机辅助评分系统。根据统计分析，当使用计算机辅助评分系统评估时，胚胎的着床受到第 3 天的卵裂球数量和大小的影响，而使用标准评分系统时，胚胎的着床受到第 3 天的所有胚胎参数的影响。对两种评分系统进行联合分析表明，使用计算机辅助评分系统时，胚胎着床受卵裂球数量和大小的影响，使用标准评分系统时，胚胎碎片程度受影响。活产受两种评分系统评估的第 3 天的卵裂球数量的影响。使用计算机辅助评分系统预测胚胎着床和活产更好。总之，在预测胚胎着床和活产方面，计算机辅助评分系统可能优于标准评分系统。
