Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2015 Jan;32(1):61-8.
doi: 10.1007/s10815-014-0366-1. Epub 2014 Oct 21.

Using the Eeva Test™ adjunctively to traditional day 3 morphology is informative for consistent embryo assessment within a panel of embryologists with diverse experience

Michael P Diamond  1 , Vaishali Suraj, Erica J Behnke, Xinli Yang, Marlane J Angle, Jaclyn C Lambe-Steinmiller, Rachel Watterson, Kelly Athayde Wirka, Alice A Chen, Shehua Shen
Affiliations
Clinical Trial

Using the Eeva Test™ adjunctively to traditional day 3 morphology is informative for consistent embryo assessment within a panel of embryologists with diverse experience

Michael P Diamond et al. J Assist Reprod Genet. 2015 Jan.

Abstract

Purpose: Since many transferred, good morphology embryos fail to implant, technologies to identify embryos with high developmental potential would be beneficial. The Eeva™ (Early Embryo Viability Assessment) Test, a prognostic test based on automated detection and analysis of time-lapse imaging information, has been shown to benefit embryo selection specificity for a panel of three highly experienced embryologists (Conaghan et al., 2013). Here we examined if adjunctive use of Eeva Test results following morphological assessment would allow embryologists with diverse clinical backgrounds to consistently improve the selection of embryos with high developmental potential.

Methods: Prospective, double-blinded multi-center study with 54 patients undergoing blastocyst transfer cycles consented to have embryos imaged using the Eeva System, which automatically measures key cell division timings and categorizes embryos into groups based on developmental potential. Five embryologists of diverse clinical practices, laboratory training, and geographical areas predicted blastocyst formation using day 3 morphology alone and day 3 morphology followed by Eeva Test results. Odds ratio (OR) and diagnostic performance measures were calculated by comparing prediction results to true blastocyst outcomes.

Results: When Eeva Test results were used adjunctively to traditional morphology to help predict blastocyst formation among embryos graded good or fair on day 3, the OR was 2.57 (95 % CI=1.88-3.51). The OR using morphology alone was 1.68 (95 % CI=1.29-2.19). Adjunct use of the Eeva Test reduced the variability in prediction performance across all five embryologists: the variability was reduced from a range of 1.06 (OR=1.14 to 2.20) to a range of 0.45 (OR=2.33 to 2.78).

Conclusions: The Eeva Test, an automated, time-lapse enabled prognostic test, used adjunctively with morphology, is informative in helping embryologists with various levels of experience select embryos with high developmental potential.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Eeva High and Eeva Low scores correlate to a high or low probability of blastocyst formation for all embryos (n = 716) and for those denoted as morphologically good/fair (n = 652). For both populations, blastocyst formation rates were significantly higher in the Eeva High group than in the Eeva Low group. *p < 0.0001 (error bars represent upper 95 % confidence intervals)
Fig. 2
Fig. 2
Odds ratio for predicting blastocyst formation using Morphology Only (left) and Morphology followed by Eeva Test (right). Odds ratios and 95 % confidence intervals were calculated for all embryos (represented in gray) and for the subset of embryos graded as good/fair (represented in blue)
Fig. 3
Fig. 3
a Overall odds ratio, b mean positive predictive value (PPV) and mean negative predictive value (NPV) across all embryologists predicting blastocyst formation using Morphology Only and Morphology followed by Eeva Test, among good/fair embryos. *p = 0.02, ns not significant (error bars represent upper 95 % confidence intervals)
Fig. 4
Fig. 4
Consistent improvement in odds ratios for individual embryologists who predicted blastocyst formation using Morphology Only and Morphology followed by Eeva Test, among good/fair embryos
See this image and copyright information in PMC

References

    1. Van Montfoort AP, Dumoulin JC, Kester AD, Evers JL. Early cleavage is a valuable addition to existing embryo selection parameters: a study using single embryo transfers. Hum Reprod. 2004;19(9):2103–8. doi: 10.1093/humrep/deh385. - DOI - PubMed
    1. Diamond MP, Willman S, Chenette P, Cedars MI. The clinical need for a method of identification of embryos destined to become a blastocyst in assisted reproductive technology cycles. J Assist Reprod Genet. 2012;29(5):391–6. doi: 10.1007/s10815-012-9732-z. - DOI - PMC - PubMed
    1. Practice Committee of Society for Assisted Reproductive T. Practice Committee of American Society for Reproductive M Elective single-embryo transfer. Fertil Steril. 2012;97(4):835–42. doi: 10.1016/j.fertnstert.2011.11.050. - DOI - PubMed
    1. Paternot G, Devroe J, Debrock S, D’Hooghe TM, Spiessens C. Intra- and inter-observer analysis in the morphological assessment of early-stage embryos. Reprod Biol Endocrinol: RB&E. 2009;7:105. doi: 10.1186/1477-7827-7-105. - DOI - PMC - PubMed
    1. Paternot G, Debrock S, D’Hooghe T, Spiessens C. Computer-assisted embryo selection: a benefit in the evaluation of embryo quality? Reprod Biomed Online. 2011;23(3):347–54. doi: 10.1016/j.rbmo.2011.05.007. - DOI - PubMed

Publication types