Abstract
BackgroundThe aim of this study was to determine the intra- and inter-observer variability in the evaluation of embryo quality. Multilevel images of embryos on day 1, day 2 and day 3, were analysed using different morphological parameters.MethodsMultilevel images of embryos on day 1, day 2 and day 3, were analysed using a standard scoring system. The kappa coefficient was calculated to measure intra- and inter-observer variability before and after training sessions.ResultsGood to excellent intra-observer agreement was present for most parameters exceptions being scoring the position of pronuclei and the presence of a cytoplasmic halo on day 1, multinucleation on day 2 and the size of fragments on day 3. Inter-observer agreement was only good to excellent for the number of blastomeres on day 2 and day 3 and the orientation of the cleavage axes on day 2. Training sessions had a positive impact on inter-observer agreement.ConclusionIn conclusion, assessment of morphological characteristics of early stage embryos using multilevel images was marked by a high intra-observer and a moderate inter-observer agreement. Training sessions were useful to increase inter-observer agreement.
Highlights
The aim of this study was to determine the intra- and inter-observer variability in the evaluation of embryo quality
The scoring of cleavage stage embryos involves the direct evaluation of the embryo by an embryologist assessing the morphological parameters to determine embryo quality [1]
Embryo scoring system The multilevel images were presented to the embryologists on a patient-by-patient basis and shown in a chronological order of embryo development
Summary
The aim of this study was to determine the intra- and inter-observer variability in the evaluation of embryo quality. Many different classification and scoring systems, based on cleavage and morphological parameters, have been proposed to evaluate embryo quality [2,3,4]. None of these grading systems has been completely validated [5,6]. The scoring of cleavage stage embryos involves the direct evaluation of the embryo by an embryologist assessing the morphological parameters to determine embryo quality [1]. Only limited and controversial data [8,9] are available with respect to intraand inter-observer variability in the evaluation of morphological parameters assessing embryo quality.
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