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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Adjunct Lecturer Julius Hreinsson, Sahlgrenska University Hospital, Sweden
- Second opponent: Professor Trine B. Haugen, Oslo Metropolitan University, Norway
- Third member and chair of the evaluation committee: Professor Anne Cathrine Staff, University of Oslo
Chair of the Defence
Professor Emeritus Johanne Sommerschild Sundby, University of Oslo
Principal Supervisor
Senior Researcher Ritsa Storeng, Oslo University Hospital
Summary
Assisted reproductive technologies (ART) such as in vitro fertilisation (IVF) are intended to treat infertility. The desired outcome of the treatment is the birth of a healthy singleton child at term.
In IVF, embryo selection when performing embryo transfer, is a crucial step in determining the possible success of the treatment. As such, the introduction of novel technologies like time lapse imaging (TLI) in clinical practice is of importance.
TLI detects subtle kinetic variations between developmental events in morphologically similar embryos. Models of selection/deselection, prior to embryo transfer, incorporating morphokinetic parameters have mainly predicted pregnancy rates, rather than live birth rates.
The aims of the thesis were to identify morphological and morphokinetic TLI biomarkers observed in the first 44 hours of development in IVF derived human embryos and to ascertain whether these biomarkers may be used to predict live birth following IVF treatment.
We found that the morphokinetic variables: time to 2-cells (t2), and second cell cycle duration (cc2) were pivotal in predicting live birth probabilities, and central for designing Day 2 embryo selection algorithms. We also found that the nucleation status of a 2-cell embryo was crucial in predicting live birth following IVF. TLI-based live birth prediction models incorporating maternal age did not improve the predictive accuracy, but these models due to their relatively high predictive value may assist clinicians in counselling prospective patients regarding their live birth probabilities.
Limited divergence of predictive pre-transfer information between implantation and live birth data is vital for novice TLI users to design in-house prediction models for later validation, rather than copying established models.
To conclude, incorporating t2, cc2, 2- cell nucleation status, and morphology strengthens embryo selection regimes during IVF treatment.
Additional information
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