Decision support tools scoring embryos according to their statistical viability by applying a number of criteria to the embryos
Purpose For embryo evaluation.
With time-lapse technology, images are taken continuously as an embryo develops. The resulting film sequence can reveal critical events that are often missed in the “snap-shot” glimpses of conventional microscopy, allowing you to make more informed decisions. EmbryoViewer software allows you to perform advanced embryo analysis to improve selection of embryos most suited for transfer and cryopreservation.
With EmbryoViewer software, you can achieve improved selection, or de-selection, of embryos by a combination of discovering both morphological and morphokinetic parameters. Important parameters such as the dynamic morphology, critical cleavage patterns and morphokinetics can only be observed with time-lapse technology.
Traditional embryo assessment has been reported to miss more than 70% of embryo multinucleation while more than 20% of embryos have been reported to go through an abnormal cleavage pattern. Such patterns can only be precisely determined by the use of
time-lapse.1-4
With EmbryoViewer software, you can review, annotate and compare development of selected embryos from data acquired by the EmbryoScope and EmbryoScope+. The same EmbryoViewer software can be used for both types of incubators. The incubators’ running conditions are automatically stored with the patient data and can be observed on the EmbryoViewer software for quality assurance.
With EmbryoViewer software, you can annotate cell division events, providing an easy overview of observations in developmental stages. High quality Hoffman modulation contrast images allow observation of key morphological events. Automatically calculated cellular activity indicate cell division events (patented).
View and compare all of patient’s embryos from an EmbryoSlide culture dish at the same time. Select a single embryo for annotation or use “View slide” to perform a side-by-side comparison of all embryos in a culture dish.
With EmbryoViewer software, you also have the possibility to set up one or more models according to clinic specific criteria and rank embryos accordingly using the Compare & Select feature. With the possibility to define selection, deselection or information criteria and even user defined variables, you can create customised models with criteria fitting your own clinical data.
Guided Annotation is an added, optional tool in the EmbryoViewer software designed to provide a simplified annotation workflow. The intelligent annotation system jumps to likely division timings based on our unique blastomere activity measurements – you simply confirm the event with the press of a button.
The Guided Annotation tool uses image analysis to guide you to likely timings for developmental events like division timings, morphology assessment and PN check. Simply validate or score the event by a single keyboard click.
Based on the annotation strategy, Guided Annotation automatically prompts you to annotate the selected variables. A continuous overview of the process is provided.
An efficient workflow is easily achieved by utilising customised annotation strategies in combination with the intuitive and ergonomics friendly keyboard shortcuts.
Define an annotation strategy, or determine which predefined annotation strategy to use, and collect consistent and valuable information by all staff.
Guided Annotation in synergy with KIDScore optimally supports your consistent embryo evaluation process.
• Improves the decision-making process
• Enhances consistency
• Helps you obtain better results
KIDScore assigns an objective score to each embryo. The scores reflect implantation potential and provide consistent and effective support for embryo selection.
The KIDScore decision support tool is developed by analysing the world’s largest database of embryo development with known clinical outcome. The models are developed by analysing how embryo morphokinetics, cleavage patterns and morphology correlates with implantation outcome after transfer.
• Improved consistency of evaluation and lower interobserver variability5
• Uses ‘easy-to-annotate’ variables
• Based on Known Implantation Data (KID) from the day of transfer
• A powerful tool when you have more embryos available than planned for transfer
• Designed to predict implantation
When to use it
• When deciding between embryos that reach expected stage on day 3
• When D3 SET is preferred
How does it work?
KIDScore D3 assigns a morphokinetic score from 1-5 to your annotated embryos. The score from 1-5 is a relative measure of the implantation potential of the embryo. The following variables need to be annotated in accordance with specific guidelines: PN assessment, PN fading, time (t) to 2, 3, 4, 5 and 8 cells.
KIDScore D3 & implantation data
The chart represents unselected embryos, embryos chosen for transfer, implanted embryos and embryos resulting in a live birth from cycles where known outcome data is available. The distribution of embryos across score groups is shown. This indicates that there is excellent concordance between the model and embryos with high implantation potential.
When to use it?
• When more good quality blastocysts are available than are planned for transfer
• When deciding which embryos are suitable for biopsy or diagnosis
How does it work?
KIDScore D5* considers the morphology and the morphokinetic traits of an embryo. For each embryo the model calculates a continuous score from 1-9.9. The score reflects the statistical chance of implantation based on development information from the five-day culture period. The higher the score, the greater the statistical chance of implantation. Only a few annotations are required to obtain a score, which further improves the worfklow.
KIDScore D5 & implantation data
KIDScore D5 scores show an increased relative implantation with higher scores. The model is based on a large database of KID blastocysts originating from a wide range of IVF clinics.
*KIDScore D5 can only be used when culturing under reduced oxygen conditions
We have seen improved IVF outcomes since we introduced EmbryoScope time-lapse system in 2013. We owe it to our patients to use time-lapse - to give them the best possible result.
- Helen Hunter, principal embryologist, Department of Reproductive Medicine, Saint Mary's Hospital, Manchester, UK
Dr. Markus Montag has written a white paper where he discusses the clinically proven results with time-lapse, as well as how time-lapse can improve the workflow in the lab and facilitate communication.
EmbryoScope+ is designed to meet the needs of clinics wishing to implement time-lapse as a standard of care to more of their patients.
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EmbryoScope time-lapse system continues to offer safe embryo management through a platform of products and services.
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By using existing incubators, you maintain your clinic’s trusted culture environment.
Learn moreReferences
1. Ergin, E.G. et al., (2014), Fertil Steril 102(4): 1029-1033 e1.
2. Data on file.
3. Rubio, I. et al., (2012), Fertil Steril 98(6): 1458-63.
4. Zhan, Q. et al., (2016) PLoS One 11(12): e0166398.
5. Sundvall, et al., (2013), Hum Reprod 28(12): 3215-21.
Tech notes
Technote Guided Annotation - setting up
This technote describes how the Guided Annotation tool is set up in a completely customisable way to support the needs and strategies of your clinical workflow. This tool is designed to support the busy workdays in the laboratory and guides you from variable to the next in an annotation strategy and by automatically forwarding the embryo images to estimated timings of events. Guided Annotation in synergy with KIDScore models otpimally supports your consitent embryo assessment process.
Tech notes
Technote Working efficiently with annotations
This technote describes how to register relevant embryo development events and working efficiently with annotations.
Tech notes
Technote Guidelines for blastocyst morphology grading with time-lapse
This technote describes the grading of blastocyst morphology with the use of time-lapse technology. This facalitates a more thorough evaluation because the complete course of development can be considered. A comprehensive impression of the blastocyst can be used as the basis for grading morphology, which should be utilised when grading ICM and TE and is neccessary when using KIDScore D5.
Tech notes
Technote - Consistent annotation for better evaluation - a guide on definitions for morphokitetics
This technote describes the definitions of variables most commonly used in embryo assessment with time-lapse. These definitions will help you attain consistent annotations and thereby objective evaluations in your clinic and further streamline the understanding of embryo developmental events within the clinic and beyond the clinic.
Tech notes
Technote Effect and prevalence of embryo developmental traits
This technote contains a summary of the prevalence and effect of developmental traits which can only be observed with time-lapse.
Tech notes
Technote Guidelines for getting started with models in Compare & Select
This technote gives you simple starting tips to make the most of your data when using morphokinetics to build a model customised for your clinic.
Tech notes
Technote Exporting data from the EmbryoViewer Software
This technote provides instructions on exporting data from the EmbryoViewer Software. In order to analyse your morphokinetic data, you will need to export to a file format which is easy to use with data analysis programs.
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