Deprioritize embryos at risk of being aneuploid with EMBRYOLY

05.09.2023

About us & our product

ImVitro’s SaaS platform EMBRYOLY is an AI-powered software. EMBRYOLY’s core feature provides a ranking based on the embryo’s morphokinetics as well as a subsequent transfer priority recommendation personalized to the patient for increased accuracy. See our product page for more information!

The challenge

Many aneuploid embryos will not lead to a clinical pregnancy [Capalbo et al, 2022] – preimplantation genetic testing (PGT-A) is sometimes used in addition to morphological or morphokinetic evaluation to identify them, especially for patients above 35 y.o. who are at higher risks of having aneuploid embryos because of a decreasing oocyte quality.

EMBRYOLY’s score has been shown to be predictive of pregnancy potential, and thus to help deprioritize embryos for transfer. Is it also indicative of the embryo’s aneuploïdy potential? This would further confirm that EMBRYOLY’s score is a valuable data point to aid embryologists in deprioritizing embryos for transfer.

Questions to answer

  • Can EMBRYOLY help deprioritize potential aneuploid embryos across all ages?
  • Can EMBRYOLY rank embryos based on their likelihood of aneuploidy across all ages?
  • How often does EMBRYOLY deprioritize potential aneuploid embryos for women >35 y.o., in a center where only embryos sent for PGT-A are considered vs. a center where PGT-A cannot be used?

The study at a glance

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83%

of aneuploidy rate in EMBRYOLY's lowest transfer priority group

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+3%

likelihood of aneuploidy for each 0.01 decrease in EMBRYOLY score

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10%

deprioritized embryos (59% when PGT-A cannot be performed)

Dataset

EMBRYOLY’s algorithms were applied on data coming from a Spanish clinic with N = 434 egg retrievals corresponding to N = 1324 embryos. Out of these, 896 embryos went through PGT-A, including N = 439 aneuploid (4.9%), N = 321 euploid (35.8%) and N = 86 mosaic embryos (9.6%). PGT-A results were categorized either as: aneuploid, mosaic, euploid or without diagnostic if the test did not work. The number of embryos that had been sent for PGT-A per egg retrieval was N = 3.05±2.08, corresponding on average to 74% of the cohort.

This data was acquired through a GERI® (Genea BiomedX) time-lapse system and not used in EMBRYOLY’s training described in Human Reproduction. As a comparison, data from an IVF center in France that does not perform PGT-A (N = 3063 embryos) was used to estimate how often embryos are deprioritized and thus potentially aneuploid.

Aneuploidy rate was defined as the number of aneuploid embryos divided by the number of euploid, mosaic and aneuploid embryos. Results were considered for different age groups, especially for women below and above 35 y.o., to account for the age-dependency of aneuploidy rates.

Findings

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Across all ages, EMBRYOLY's personalized transfer recommendations correlate with aneuploidy risk: the positive predictive value (i.e aneuploidy rate) in the lowest transfer recommendation group was 83% (N = 13 embryos) vs. 48% in the second lowest (N= 106 embryos), 43% in the the second highest (N= 82 embryos) and 36% in the highest group (N = 59 embryos). The lowest transfer recommendation group was populated exclusively by women > 35 y.o whereas the highest transfer recommendation group contained a majority of women < 35 y.o., which is consistent with the known association between maternal age and aneuploidy risk.

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EMBRYOLY's score was statistically associated with the risk of aneuploidy of an embryo (logistic regression, N = 608 embryos, p-value < 0.01, OR = 1.03): the lower the score, the higher the risk of an embryo being aneuploid. This remained true both for patients ≤35 y.o. (N = 195 embryos; p<0.01), and> 35 y.o. (N = 381 embryos; p=0.04).

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10% of the PGT-A tested embryos would have been deprioritized by EMBRYOLY. In comparison, 59% embryos would have been deprioritized in a French IVF center where no PGT-A is performed and thus all embryos considered.

Conclusion at a glance

This case study illustrates that EMBRYOLY’s transfer recommendation often deprioritizes embryos that are aneuploid, especially for women above 35 y.o. More specifically, it confirms that EMBRYOLY’s score can rank embryos according to their likelihood of being aneuploid. 

Note that the correlation between EMBRYOLY’s score and PGT-A results can inherently only be validated in patients that have gone through PGT-A, which can bias the dataset. However, results were reported both in women below (33%) and above (67%) 35 y.o.. These results are therefore not only representative of the patient population of 35+ y.o. that is typically recommended to go through PGT-A [Imudia et al, 2020].

Finally, please note that EMBRYOLY estimates a risk but does not provide any ploidy diagnosis. 

Contact us for a demo to see how our algorithms perform on your data.