Since many transferred embryos with "good morphology" fail to implant, technologies are needed to distinguish embryos with highest developmental competence. We developed and validated an integrated time-lapse and automated image analysis system which measures specific cell division timings and predicts blastocyst development by day 2. The objective of this study was to determine the degree of improvement to viable embryo selection when using our prediction model with traditional morphology. Multi-site, prospective, cohort study. The study included 43 patients (≤42 years old) undergoing in vitro fertilization at 3 clinics. Day 3 morphology and time-lapse image data captured by an integrated imaging system, Eeva (Early Embryo Viability Assessment), were prospectively collected. Eeva generated a blastocyst probability score (Low, High) based on specific cell division timings. Eeva blastocyst probability was determined to be High when all cell division timings were within the defined ranges. Five experienced embryologists made a "blastocyst" or "arrest" prediction for each embryo using Day 3 Morphology only, and then using Morphology and Eeva scores. The prediction results were compared to true blastocyst outcomes. A total of 343 embryos were evaluated. By combining Morphology+Eeva, the average blastocyst prediction accuracy significantly improved. The degree of improvement was augmented for embryos with "good morphology" on day 3.Tabled 1Blastocyst Prediction on Day 3 (% Accuracy, Mean±SD)Embryo GroupsMorphology onlyMorphology+EevaP valueTotal Embryos (n=343)62±680±2<0.0056 to 10-cell, ≤10% Frag, Perfect Symmetry (n=135)37±466±4<0.005 Open table in a new tab Adding Eeva to traditional morphology dramatically improved day 3 blastocyst prediction, particularly among "good morphology embryos". Predictions are non-invasive and available by day 2 using automated analysis. Eeva is a uniquely effective and efficient tool for viable embryo selection that may ultimately improve implantation rates.
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