Manual of Embryo Selection in Human Assisted Reproduction

The selection of the best embryo for transfer is critical for successful in vitro fertilization (IVF), and there are numerous methods used to assess embryo viability. This manual provides an overview of the tools available to assist in embryo selection, as well as evidence for their efficacy and safety, and the broader considerations that must underlie these important clinical decisions.

Format: Paperback / softback
Length: 192 pages
Publication date: 26 January 2023
Publisher: Cambridge University Press

Selecting the most suitable embryo for transfer to the uterus is a critical factor in the success of in vitro fertilization (IVF). Extensive research has been dedicated to this field, employing a wide range of methods to evaluate the newly fertilized embryo's genome and metabolism. While some techniques have a robust evidence base, others require expert opinion due to a lack of adequate information. In clinical practice, it is essential to rank all embryos within a cohort based on their viability to facilitate the selection of the best embryo, aiming to optimize live birth outcomes. This metric is widely used to measure and rate IVF clinics worldwide.

This comprehensive manual aims to provide embryologists and clinicians with an overview of the available tools for embryo selection, along with evidence supporting their efficacy and safety. It also delves into the broader considerations that underpin these critical clinical decisions. By leveraging these resources, embryologists and clinicians can make informed choices that enhance the chances of achieving a successful pregnancy and delivering a healthy baby.

The selection of the best embryo for transfer is a complex process that involves multiple factors. Here are some key considerations that embryologists and clinicians should take into account:

Embryo Quality: The quality of the embryo is a critical factor in determining its viability and potential for successful implantation. Factors such as the number and quality of chromosomes, the morphology of the embryo, and its ability to divide and grow are important considerations.

Embryo Age: The age of the embryo can also impact its viability. Younger embryos tend to have higher rates of cleavage and growth, while older embryos may have a higher risk of chromosomal abnormalities.

Embryo Morphology: The morphology of the embryo, including its size, shape, and structure, can provide insights into its developmental potential. Embryos with a normal morphology are more likely to develop into healthy embryos that can be successfully transferred.

Embryo Genome: Molecular biological techniques, such as next-generation sequencing (NGS), can assess the genome of the embryo and identify any genetic abnormalities or mutations that may increase the risk of miscarriage or birth defects.

Embryo Metabolism: Embryo metabolism can also be evaluated using molecular biological techniques. This can provide insights into the embryo's energy requirements and its ability to metabolize nutrients, which can impact its development and growth.

Embryo Culture Conditions: The culture conditions in which the embryo is grown can also impact its development and viability. Factors such as the type of culture media, the temperature, the humidity, and the oxygen concentration can all play a role in the embryo's growth and development.

Embryo Selection Methods: There are several methods used to select the best embryo for transfer, including morphological assessment, molecular biological techniques, and embryo scoring systems. Each method has its advantages and disadvantages, and the choice of method depends on the specific circumstances of the patient and the available resources.

Evidence-Based Approaches: Embryologists and clinicians should rely on evidence-based approaches to embryo selection to ensure that they are making informed decisions that are supported by scientific evidence. This includes reviewing the literature, conducting clinical trials, and following established guidelines and protocols.

Ethical Considerations: Embryo selection raises ethical considerations, particularly when dealing with embryos that are not expected to result in a live birth. Embryologists and clinicians should consider the ethical implications of their decisions and ensure that they are acting in the best interests of the patient and the potential child.

In conclusion, selecting the best embryo for transfer is a critical component of IVF success. Embryologists and clinicians must rely on a combination of scientific evidence, expert opinion, and ethical considerations to make informed decisions that optimize live birth outcomes. By utilizing the tools and information provided in this manual, embryologists and clinicians can enhance their ability to select the most suitable embryo for transfer and increase the chances of achieving a successful pregnancy.

Weight: 478g
Dimension: 189 x 247 x 21 (mm)
ISBN-13: 9781009016377