Over 80 competency assessment modules were created for sperm and embryo morphology, quality, viability and common clinical decision timepoints. Validation studies are underway, using images of PAP stained morphology slides for andrology modules, and 112 cleavage stage images captured on EmbryoScope 66 hours post insemination, and 168 blastocyst stage images captured on EmbryoScope 115 and 139 hours post insemination for embryology modules. Each slide was rotated and repeated 3 times throughout the modules to allow for intra-observer variability measurements. This work was presented as an abstract and poster at the Foundation for Reproductive Medicine Conference in New York City, November 17-19, 2018.
Test Protocol Standardization and Check for Understanding
Rigorously standardized test protocols are essential for meaningful comparisons across multiple sites. Before each assessment can begin, a standardized and detailed protocol is displayed, followed by a quick “Check for Understanding” module to ensure that test takers understand the instructions and how to take the test. ART Compass is flexible; it can serve standardized specimens to each technologist at each study site simultaneously, allowing even very small IVF clinics to compare individual values to the mean of all technologists, or to technologists in a central laboratory.
Clinical Decision Making
Embryologists rely on morphological assessments when assessing sperm morphology, sperm quality and when performing semen analyses and when selecting sperm for ICSI. Once a sperm has been identified for injection, embryologists immobilize the cell by breaking the tail with an ICSI needle. Breaking the cell membrane invokes subsequent physiological and biochemical reactions, which promotes decondensation of the sperm head and activation of the oocyte. Staff are trained to avoid contact with the midpiece region of the sperm as this contains the centriole, which plays a major role in the cleavage patterns of the developing embryo. The location of the immobilization step can be visually determined in the ART Compass app.
Additionally, cleavage stage embryo morphological assessments are performed to evaluate embryo quality. These scores are used to make clinical decisions such as determining the day of transfer (Day 3 vs Day 5), determining the number of embryos to transfer, selecting the top-quality embryo(s) for transfer, as well as determining the final disposition of embryos. ART Compass provides assessments for each of these parameters.
Blastocyst stage embryo morphological assessments are performed to evaluate embryo quality. These scores are used to make clinical decisions regarding the number of embryos to transfer, selecting the top-quality embryo(s) for transfer, as well as determining the final disposition of embryos. ART Compass provides assessments for each of these parameters and more.