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

  • Assisted Reproduction Technologies
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Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

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.

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Acknowledgments

We acknowledge Auxogyn, Inc. for sponsoring this study, the clinical, scientific and algorithm groups at Auxogyn for insightful discussion, and the physicians, embryologists and patients who participated in the development and validation of the Eeva Test.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Georgia Regents University, 1120 15th Street, BA-7300, Augusta, GA, 30912, USA

    Michael P. Diamond

  2. Auxogyn, Inc, 1490 O’Brien Drive, Suite A, Menlo Park, CA, 94025, USA

    Vaishali Suraj, Kelly Athayde Wirka, Alice A. Chen & Shehua Shen

  3. Institute for Reproductive Health, 3805 Edwards Rd. Suite 455, Cincinnati, OH, 45209, USA

    Erica J. Behnke

  4. San Francisco Medical Center, University of California, 2536 Sutter St., San Francisco, CA, 94115, USA

    Xinli Yang

  5. Laurel Fertility Care, 1700 California St. Suite 570, San Francisco, CA, 94109, USA

    Marlane J. Angle

  6. Reproductive Medicine Institute, 2425W. 22nd St. Suite 102, Oak Brook, IL, 60523, USA

    Jaclyn C. Lambe-Steinmiller

  7. Art Labs Unlimited, Ltd., Streamwood, IL, USA

    Rachel Watterson

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  1. Michael P. Diamond
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Corresponding author

Correspondence to Michael P. Diamond.

Additional information

Capsule The Eeva Test is highly informative and, when used adjunctively to morphology, allows embryologists from diverse clinical backgrounds to consistently improve embryo selection.

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Supplementary Figure 1

Morphological grade assignments (A, B, C, and D) made by five embryologists using day 3 morphology data for n=758 embryos. (GIF 52 kb)

(TIFF 47 kb)

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Diamond, M.P., Suraj, V., Behnke, E.J. et al. Using the Eeva Test™ adjunctively to traditional day 3 morphology is informative for consistent embryo assessment within a panel of embryologists with diverse experience. J Assist Reprod Genet 32, 61–68 (2015). https://doi.org/10.1007/s10815-014-0366-1

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