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      The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting

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          Abstract

          Many variations in oocyte and embryo grading make inter-laboratory comparisons extremely difficult. This paper reports the proceedings of an international consensus meeting on oocyte and embryo morphology assessment. Background presentations about current practice were given. The expert panel developed a set of consensus points to define the minimum criteria for oocyte and embryo morphology assessment. It is expected that the definition of common terminology and standardization of laboratory practice related to embryo morphology assessment will result in more effective comparisons of treatment outcomes. This document is intended to be referenced as a global consensus to allow standardized reporting of the minimum data set required for the accurate description of embryo development.

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          Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer.

          David Gardner, Michelle Lane, John Stevens … (2000)
          To determine the relationship between blastocyst score and pregnancy outcome. Retrospective review of blastocyst transfer in an IVF clinic. Private assisted reproductive technology unit. 107 patients undergoing blastocyst culture and transfer of two embryos. Culture of all pronucleate embryos in sequential media to the blastocyst stage (day 5), followed by transfer of two blastocysts. Implantation rates, pregnancy rates, and twinning were analyzed. When a patient received two top-scoring blastocysts (64% of patients), implantation and pregnancy rates were 70% and 87%, respectively. The twinning rate in this group was 61%. When only one top-quality blastocyst was available for transfer (21% of patients), the implantation and pregnancy rates were 50% and 70%. The twinning rate for this group was 50%. In contrast, when only low-scoring blastocysts were available for transfer (15% of patients), implantation and pregnancy rates were 28% and 44%, and the twinning rate was 29%. No monozygotic twins were observed in this group of patients. The ability to transfer one high-scoring blastocyst should lead to pregnancy rates greater than 60%, without the complication of twins.
          Article 0 comments Cited 315 times – based on 0 reviews     Review now
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            Culture and transfer of human blastocysts.

            W Schoolcraft, Robert Gardner (1999)
            The transfer of the human embryo at the blastocyst stage during an in-vitro fertilization procedure is a way of increasing implantation rates. This, in turn, means that significantly fewer embryos are required to be transferred in order to establish a successful pregnancy. The result of this is that high order multiple gestations are eliminated, while maintaining high pregnancy rates, in in-vitro fertilization.
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              Characterization of a top quality embryo, a step towards single-embryo transfer.

              Michel van Agthoven, J Gerris, W Eestermans … (1999)
              In most in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) programmes approximately one ongoing pregnancy in three is multiple. The need to characterize embryos with optimal implantation potential is obvious. We retrospectively examined all of 23 double transfers resulting in ongoing twins, occurring between January 1, 1996 and May 19, 1997. Characteristics of these top quality embryos were absence of multinucleated blastomeres, four or five blastomeres on day 2, seven or more cells on day 3, and 2 embryos, 11/31 (35%) were multiple. We applied our top quality criteria to the 221 double transfers: 106 transfers with two top embryos resulted in 65 (63%) ongoing pregnancies with 37 (57%) twins, 65 transfers with one top embryo in 38 (58%) ongoing pregnancies with eight (21%) twins. In the group without top embryos, 12/52 (23%) ongoing singletons occurred, with no twins. The corresponding ongoing implantation rates were 49, 35 and 12%. This analysis suggests that single embryo transfer with an acceptable pregnancy rate might be considered if a top quality embryo is available.
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                Author and article information

                Journal
                Title: Human Reproduction
                Abbreviated Title: Human Reproduction
                Publisher: Oxford University Press (OUP)
                ISSN (Print): 0268-1161
                ISSN (Electronic): 1460-2350
                Publication date Created: May 17 2011
                Publication date Created: June 01 2011
                Publication date (Electronic): April 18 2011
                Publication date (Print): June 01 2011
                Volume: 26
                Issue: 6
                Pages: 1270-1283
                Article
                DOI: 10.1093/humrep/der037
                PubMed ID: 21502182
                SO-VID: abb7584b-79e0-459f-b3a3-5a591e21779d
                Copyright © © 2011
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