Abstract
Two systems for measuring embryo development in vitro were evaluated. One was a 1–4 scale based on a subjective evaluation of embryo quality (EQ) from microscopic appearance. In addition, a formula for scoring embryo growth rate in vitro was developed. The embryo development rating (EDR) was based on the ratio between the time at which embryos were observed at a particular stage after insemination and the time at which they would be expected to reach that stage in a hypothetical “ideal” growth rate with a cell cycle length of 11.9 hr. Using this scoring system, “normally” growing embryos scored 100. This approach was aimed at partially normalizing the data and allowed all embryos to be analyzed similarly regardless of the time of observation. Analysis of 1539 embryo replacements resulting in 232 clinical pregnancies showed that both EDR and embryo-quality scores were of value in predicting success, with clinical pregnancy most likely to eventuate from a combination of moderate to good EQ scores (2–4) coupled with average or above-average growth rates (EDR scores from 90 to 129). Poor-quality and very slowly or very rapidly growing embryos were underrepresented in cycles that proceeded to pregnancy. These inferences were based on all embryos transferred (mean, 2.73 per transfer cycle), and they were substantiated by an analysis of 33 pregnancies resulting from replacement of a single embryo and from 18 pregnancies in which all embryos scored the same with both systems. EQ and EDR were significantly associated with each other and together provide a valuable guide in predicting pregnancy, in selecting embryos for freezing, and in monitoring day-to-day performance in the in vitro fertilization (IVF) program.
Similar content being viewed by others
References
Edwards RG: Conception in the Human Female. London, Academic Press, 1980
Trounson AO, Mohr LR, Wood C, Leeton JF: Effect of delayed insemination on in vitro fertilization, culture and transfer of human embryos. J Reprod Fertil 1982;64:285–294
Mohr LR, Trounson AO, Leeton JF, Wood C: Evaluation of normal and abnormal human embryo development during procedures in vitro.In Fertilization of the Human Egg in Vitro: Biological Basis and Clinical Applications, HM Beier, HR Lindner (eds). Berlin, Springer-Verlag, 1983, pp 211–221
Mohr LR, Trounson AO: In vitro fertilization and embryo growth.In Clinical In Vitro Fertilization, C Wood, AO Trounson (eds). Berlin, Springer-Verlag, 1984, pp 99–115
Ball GD, Coulam CB, Field CS, Harms RW, Thie JT, Byers AP: Effect of serum source on human fertilization and embryonic growth parameters in vitro. Fertil Steril 1985;44:75–79
Schlesselman JJ: How does one assess the risk of abnormalities from human in vitro fertilization? Am J Obstet Gynecol 1979;135:135–148
Pike IL: Biological risks of in vitro fertilization and embryo transfer.In Clinical In Vitro Fertilization, C Wood, AO Trounson (eds). Berlin, Springer-Verlag, 1984, pp 137–146
Sundström P, Nilsson O, Liedholm P. Cleavage rate and morphology of early human embryos obtained after artificial fertilization and culture. Acta Obstet Gynecol Scand 1981;60:109–120
Trounson A, Mohr L: Human pregnancy following cryopreservation, thawing and transfer of an eight-cell embryo. Nature 1983;305:707–709
Schilling E, Niemann H, Smidt D: Evaluation of fresh and frozen cattle embryos by fluorescence microscopy.In In Vitro Fertilization and Embryo Transfer, ESE Hafez, K Lemon (eds). MTP Press, 1982, pp 349–355
Mohr LR, Trounson AO: The use of fluorescein diacetate to assess embryo viability in the mouse. J Reprod Fertil 1980;58:139–196
McBain JC, Trounson AO: Patient management—treatment cycle.In Clinical in Vitro Fertilization, C Wood, AO Trounson (eds). Berlin, Springer-Verlag, 1984, pp 49–65
Renou P, Trounson AO, Wood C, Leeton JF: The collection of human oocytes for in vitro fertilization. An instrument for maximizing oocyte recovery rate. Fertil Steril 1981;35:409–412
Downing B: Oocyte pick-up.In Clinical in Vitro Fertilization, C Wood, AO Trounson (eds). Berlin, Springer-Verlag, 1984, pp 67–81
Quinn P, Barros C, Whittingham D: Preservation of hamster oocytes to assay the fertilizing capacity of human spermatozoa. J Reprod Fert 1980;66:161–168
Lippes J, Enders RG, Pragay DA, Bartholemew WR: The collection and analysis of human fallopian tubal fluid. Contraception 1972;5:85–103
Lopata A, Patullo MJ, Chang A, James B: A method for collecting motile spermatozoa from human semen. Fertil Steril 1976;27:677–684
Quinn P, Kerin JFP, Warnes GM, Broom TJ, McEvoy M, Seamark RF, Cox LW: Improved pregnancy rate in human IVF using a medium based on the composition of human tubal fluid. Proc Fert Soc Austral 1984:17
Quinn P, Kerin JF, Warnes GM: Improved pregnancy rate in human in vitro fertilization with the use of a medium based on the composition of human tubal fluid. Fertil Steril 1985;44:493–498
Cummins JM, Breen TM, Fuller SM, Harrison KL, Shaw JM, Wilson LM, Hennessey JF: Comparison of two media in a human in vitro fertilization program: Lack of significant difference in pregnancy rate. J Vitro Fert Embryo Transfer 1986;3:326–330
Leeton J, Trounson AO, Jessup D, Wood C: The technique for human embryo transfer. Fertil Steril 1982;38:156–161
Leeton J, Kerin J: Embryo transfer.In Clinical in Vitro Fertilization, C Wood, Trounson (eds). Berlin, Springer-Verlag, 1984, pp 117–136
Cummins JM, Breen TM, Wilson LM, Shaw JM, Hennessey JF: Embryo development rating and quality: Predictive value in IVF. Proc Fert Soc Austral 1984:6
Yanagimachi R: Zona-free hamster eggs: Their use in assessing fertilizing capacity and examining chromosomes of human spermatozoa. Gamete Res 1984;10:187–232
Trounson AO, Wood C, Leeson JF: Freezing of embryos. An ethical obligation. Med J Austral 1982;2:332–333
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cummins, J.M., Breen, T.M., Harrison, K.L. et al. A formula for scoring human embryo growth rates in in vitro fertilization: Its value in predicting pregnancy and in comparison with visual estimates of embryo quality. J Assist Reprod Genet 3, 284–295 (1986). https://doi.org/10.1007/BF01133388
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01133388