Validation of Optimized Embryo Scoring Procedures: Single-Day versus 2-Day Assessment

Area of Science:

• Reproductive Medicine
• Embryology
• Assisted Reproductive Technology (ART)

Background:

• Traditional embryo selection in assisted reproductive technology (ART) often involves two-day assessments.
• Evaluating embryo development over multiple days (e.g., Day 2+3 or Day 3+5) is standard practice.
• The efficiency of single-day embryo selection requires investigation to potentially streamline ART workflows.

Purpose of the Study:

• To compare the diagnostic performance of single-day embryo selection (Day 3 or Day 5) versus two-day selection.
• To assess sensitivity, specificity, and accuracy of single-day versus multi-day embryo evaluation.
• To determine if single-day selection is a viable option for managing ART workload.

Main Methods:

• Retrospective cohort study analyzing 9,095 patients over 15 years (2008-2023) at an ART center.
• Compared two-day selection protocols (Day 2+3, Day 3+5) with hypothetical single-day selections (Day 3, Day 5).
• Morphological embryo scoring was used, and sensitivity, specificity, and accuracy were calculated.

Main Results:

• Day 3 single-day assessment achieved 98.9% sensitivity, 93.6% specificity, and 96.7% accuracy, comparable to Day 2+3.
• Day 5 single-day assessment showed 99.5% sensitivity, 89.7% specificity, and 93.4% accuracy, similar to Day 3+5.
• Both single-day assessments demonstrated diagnostic accuracy exceeding 90%.

Conclusions:

• Single-day embryo selection on Day 3 or Day 5 offers diagnostic accuracy comparable to traditional two-day protocols.
• This method can be considered as an efficient strategy to manage increased workloads in ART.
• Further prospective randomized trials are recommended to validate these findings in clinical practice.