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Real-Time Imaging Strategies to Improve Morphological Assessment

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Human Gametes and Preimplantation Embryos

Abstract

It has been more than three decades since a physician produced the first successful pregnancy through in vitro fertilization (IVF), but the success rate for a live birth still remains disappointingly low, on average round 30 %, mainly due to the low probability of an individual embryo successfully implanting in the uterus and producing a child. While transferring more than one embryo per cycle has helped to maintain IVF pregnancy rates at an acceptable level, it has also led to a dramatic rise in the number of multiple pregnancies and the subsequent risk of complications for both the mother and developing fetuses. The embryos produced in a typical IVF cycle are extremely variable in terms of their ability to form a viable pregnancy. In cases of single embryo transfer (SET) it is therefore essential that the embryo chosen for transfer is the one having the greatest potential to form a pregnancy and produce a healthy child.

IVF technology allows for observation of early actions of human fertilization and embryogenesis. Nevertheless, concerns about excessive embryo handling have limited the frequency of microscopic observations outside the controlled incubation environment. The resulting “freeze frame” images of the active processes of growth and development necessarily limit the information available to the observer and short-lived events may be missed entirely. Additionally, most of the grading systems currently used for assessing embryo quality are made on the basis of morphological evaluation conducted in the IVF laboratory and there is currently no consensus about the most accurate method for embryo quality estimation. Grading based only on these qualitative criteria is very subjective and may be one of the main causes of the interobserver variance introduced in these methods.

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Author information

Authors and Affiliations

  1. IVI Alicante, Alicante, Spain

    María Cruz

  2. Instituto Valenciano de Infertilidad, Alicante, Spain

    Manuel Muñoz

  3. IVF Unit, Clinical Embryology Laboratory, Instituto Valenciano de Infertilidad, Valencia, 46015, Spain

    Marcos Meseguer

Authors
  1. María Cruz
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  2. Manuel Muñoz
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  3. Marcos Meseguer
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Corresponding author

Correspondence to Marcos Meseguer .

Editor information

Editors and Affiliations

  1. University of Melbourne, Department of Zoology, Royal Parade, Melbourne, 3010, Victoria, Australia

    David K. Gardner

  2. Boston IVF, Second Ave. 130, Waltham, 02451, Massachusetts, USA

    Denny Sakkas

  3. Yale School of Medicine, Dept. of Ob/Gyn & Reproductive Sciences, Cedar St. 333, New Haven, 06510, Connecticut, USA

    Emre Seli

  4. Obstetrics & Gynaecology, University of Oxford, Nuffield Department of, Garsington Road, Oxford, OX4 2HW, Oxfordshire, United Kingdom

    Dagan Wells

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Cruz, M., Muñoz, M., Meseguer, M. (2013). Real-Time Imaging Strategies to Improve Morphological Assessment. In: Gardner, D., Sakkas, D., Seli, E., Wells, D. (eds) Human Gametes and Preimplantation Embryos. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6651-2_5

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  • DOI: https://doi.org/10.1007/978-1-4614-6651-2_5

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6650-5

  • Online ISBN: 978-1-4614-6651-2

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