Department of Surgical Sciences, Gynecology and Obstetrics 1, Physiopathology of Reproduction and IVF Unit, S. Anna Hospital, University of Torino, Via Ventimiglia 3, 10126, Torino, Italy.
Department of Surgical Sciences, Clinical statistics, University of Torino, Corso Bramante, 88, Torino, Italy.
J Ovarian Res. 2019 Aug 9;12(1):73. doi: 10.1186/s13048-019-0547-8.
In this study we aimed at retrospectively assessing in a homogeneous group of IVF patients whether the addition of Early Embryo Viability Assessment (Eeva™) to standard morphology increases the accuracy of embryo selection in case of double embryo transfer (DET) on day 3 or single embryo transfer (SET) on day 5. Eeva™ is an algorhythm aimed at indicating on day 3, according to morphokinetic parameters observed in the first three days of embryo growth, which embryos are more likely to develop into viable blastocysts and implant. A total number of 328 patients were included in the study; IVF or ICSI were performed and 428 embryos were transferred, either with DET on day 5, or (when at least four top scored embryos were available on day 3) with SET of day 5. Four groups were considered: (a) patients receiving day 3 DET with embryos selected by standard morphology (DET-3 M, n = 106, receiving 212 embryos), (b) patients receiving day 3 DET with embryos selected by morphology plus Eeva™ (DET-3 ME group, n = 48, receiving 96 embryos), (c) patients receiving day 5 SET with a blastocyst selected by standard morphology (SET-5 M group, n = 126, receiving 126 embryos), and (d) patients receiving day 5 SET with a blastocyst selected by morphology plus Eeva™ (SET-5 ME group, n = 48, receiving 48 embryos). Overall, a clinical pregnancy rate of 49.1%, implantation rate of 40%, and ongoing pregnancy rate of 43.6% were observed. The implantation rate was significantly higher in DET-3 ME group than in DET-3 M group (44.8% vs. 30.2%, p < 0.02), whereas it was comparable in groups DET-3 ME, SET-5 M and SET-5 ME. Differently, the ultrasound-verified clinical pregnancy rate and the ongoing pregnancy rate at 12 weeks did not significantly differ in all four groups. Overall, our findings suggest that Eeva™ algorhythm can improve embryo selection accuracy of standard morphology when ET on day 3 is scheduled, leading to a higher implantation rate, but its impact on ongoing pregnancy and live birth needs to be further clarified.
在这项研究中，我们旨在回顾性评估一组同质的 IVF 患者，在第 3 天进行双胚胎移植（DET）或第 5 天进行单胚胎移植（SET）的情况下，添加早期胚胎活力评估（Eeva™）是否会提高胚胎选择的准确性。Eeva™ 是一种算法，旨在根据胚胎生长的前三天观察到的形态动力学参数，在第 3 天指示哪些胚胎更有可能发育成有活力的囊胚和着床。共有 328 名患者纳入研究；进行了 IVF 或 ICSI，共移植了 428 个胚胎，其中 5 天进行 DET，或者（当第 3 天至少有 4 个评分最高的胚胎时）进行 5 天的 SET。考虑了四个组：（a）接受第 3 天 DET 的患者，胚胎通过标准形态选择（DET-3M，n=106，接受 212 个胚胎），（b）接受第 3 天 DET 的患者，胚胎通过形态学加 Eeva™ 选择（DET-3ME 组，n=48，接受 96 个胚胎），（c）接受第 5 天 SET 的患者，囊胚通过标准形态选择（SET-5M 组，n=126，接受 126 个胚胎），和（d）接受第 5 天 SET 的患者，囊胚通过形态学加 Eeva™ 选择（SET-5ME 组，n=48，接受 48 个胚胎）。总体而言，观察到临床妊娠率为 49.1%，着床率为 40%，持续妊娠率为 43.6%。DET-3ME 组的着床率明显高于 DET-3M 组（44.8% vs. 30.2%，p<0.02），而 DET-3ME、SET-5M 和 SET-5ME 组之间则相似。不同的是，所有四个组的超声证实的临床妊娠率和 12 周时的持续妊娠率没有显著差异。总体而言，我们的研究结果表明，当计划在第 3 天进行 ET 时，Eeva™ 算法可以提高标准形态学的胚胎选择准确性，从而提高着床率，但它对持续妊娠和活产的影响需要进一步澄清。
