Intra- and inter-observer analysis in the morphological assessment of early-stage embryos
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BioMed Central
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Intra- and inter-observer analysis in the morphological assessment of early-stage embryos Goedele Paternot*, Johanna Devroe, Sophie Debrock, Thomas M D'Hooghe and Carl Spiessens Address: Leuven University Fertility Centre, UZ Leuven, Campus Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium Email: Goedele Paternot* - [email protected]; Johanna Devroe - [email protected]; Sophie Debrock - [email protected]; Thomas M D'Hooghe - [email protected]; Carl Spiessens - [email protected] * Corresponding author
Published: 29 September 2009 Reproductive Biology and Endocrinology 2009, 7:105
doi:10.1186/1477-7827-7-105
Received: 21 July 2009 Accepted: 29 September 2009
This article is available from: http://www.rbej.com/content/7/1/105 © 2009 Paternot et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: The 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. Methods: Multilevel 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. Results: Good 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. Conclusion: In 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.
Background Reproductive outcome in IVF depends on an interplay of different factors including embryo quality [1,2]. Many different classification and scoring systems, based on cleavage and morphological parameters, have been proposed to evaluate embryo quality [2-4]. However, none of these grading systems has been completely validated [5,6]. Reliability is one of the most important conditions for the validation of a scoring system. Currently, 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]. Some variation in scoring of morphological parameters can be expected among differen
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