External quality control for embryology laboratories

Area of Science:

• Reproductive Science
• Clinical Embryology
• Laboratory Medicine

Background:

• External quality control (EQC) programs are recommended by scientific societies for embryology laboratories.
• Standardization in embryology is crucial for consistent patient care and reliable outcomes.

Purpose of the Study:

• To evaluate the impact of a 5-year external quality control program on embryology laboratories.
• To assess inter-laboratory agreement in embryo classification and clinical decision-making.

Main Methods:

• Annual delivery of toxicity testing materials and digital images (DVD/CD-ROM) of zygotes and embryos (Days 2 and 3).
• Participants classified embryo quality and made clinical decisions based on provided materials.
• High agreement defined as >75% of laboratories achieving similar classifications.

Main Results:

• Specificity for material analysis was 68%, sensitivity was 83%.
• Agreement on embryo classification increased from 35% to 55% over the 5-year program.
• No significant improvement in agreement on clinical decisions was observed.
• Higher agreement was found for Day-3 embryo classification (58%) compared to Day-2 (32%).

Conclusions:

• Participation in EQC enhances inter-laboratory agreement on embryo classification.
• EQC programs do not currently improve agreement on clinical decision-making in embryology.
• Standardization of clinical decision-making procedures is necessary in embryology laboratories.