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Evidence-Based Approaches to Embryo Selection by Morphology and Kinetics

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Emerging Topics in Reproduction

Abstract

The success of IVF-based assisted reproductive technologies (ART) depends critically on viability and sustained in utero development of the in vitro-grown embryo. Selection of that embryo for transfer involves a judgment on the part of the clinical embryologist. For a good part of the past nearly 40 years, this judgment has been based primarily on embryo appearance—or morphology—assessed at discreet time points during culture. Some key morphological markers of viability have been identified through a multitude of retrospective observational studies. Although obviously useful and serving an important function, morphology is subjective and does not always reveal development potential. Two emerging and evolving technologies hold the promise to complement morphology: preimplantation genetic testing for aneuploidy (PGT-A) and time-lapse microscopy (TLM) for continuous monitoring of embryo development and precise timing of key developmental events. Scrutiny of time-lapse images has helped successful identification of events associated with blastulation, but predicting implantation and pregnancy still proves to be a challenge. It is clear that, to be efficacious, embryo selection platforms and algorithms must be able to select for embryos with low risk of aneuploidy or, alternatively, reliably predict implantation.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology and Women’s Health, John A. Burns School of Medicine and the Pacific In Vitro Fertilization Institute, Kapiolani Medical Center for Women and Children, Honolulu, HI, USA

    Thomas Huang PhD, HCLD

  2. Reproductive Science Center of NJ, Eatontown, NJ, USA

    Mina Alikani PhD, HCLD

Authors
  1. Thomas Huang PhD, HCLD
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  2. Mina Alikani PhD, HCLD
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Correspondence to Mina Alikani PhD, HCLD .

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Editors and Affiliations

  1. Division of Andrology, University of Utah School of Medicine, Salt Lake City, Utah, USA

    Douglas T. Carrell

  2. Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Catherine Racowsky

  3. Department of Urology, Weill Cornell Medical College, New York, New York, USA

    Peter N. Schlegel

  4. NICHD, National Institutes of Health, Bethesda, Maryland, USA

    Alan H. DeCherney

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Huang, T., Alikani, M. (2018). Evidence-Based Approaches to Embryo Selection by Morphology and Kinetics. In: Carrell, D., Racowsky, C., Schlegel, P., DeCherney, A. (eds) Emerging Topics in Reproduction. Springer, Cham. https://doi.org/10.1007/978-3-319-90823-6_10

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