Clinical validation of the early embryo viability assessment system: Analysis for the blastocyst morphology and pregnancy outcomes

Objective:To determine the relationship between the early embryo viability assessment(EEVA)and blastocyst morphological parameters and pregnancy outcomes.Methods:This retrospective cohort study was conducted on 291 intracytoplasmic sperm injection cycles including 2522 embryos with indications of prolonging embryo culture to the blastocyst stage in the Genea embryo review incubator,and 511 single vitrified-warmed blastocyst transfer cycles from January 2020 to June 2023.The EEVA system produced an EEVA score from E1(best)to E5(worse)for the potential of blastocyst formation.Blastocyst morphology was evaluated.The association between the EEVA score and each type of blastocyst morphology,implantation rate,clinical pregnancy,and ongoing pregnancy were assessed using generalized estimating equations.Results:The inner cell mass A(ICM A),trophectoderm A(TE A),blastocoele expansion degree of 3,4,5,6,7 rates were higher with lower the EEVA score.The adjusted odd ratio(aOR)(E5 vs E1)was 0.3 for ICM A,0.174 for TE A and 0.210 for BL3,4,5,6,7(all P<0.001),suggesting a significant association between lower EEVA scores and improved embryo quality.The implantation,clinical pregnancy,and ongoing pregnancy rate were also higher with lower the EEVA score.The aOR of E5 vs E1 was 0.245 for implantation,0.185 for clinical pregnancy and 0.200 for ongoing pregnancy rate(P<0.001).Conclusions:There were associations between blastocyst morphology,pregnancy outcome and EEVA scores.The good blastocyst morphology and pregnancy outcomes are higher with lower the EEVA score.

Antibiotic usage in surgical sperm retrievals among IVF centers

Surgical sperm retrieval(SSR)is currently one of the most common procedures in in vitro fertilization(IVF).However,a gap between the guidelines and routine clinical practice regarding antibiotic use in sSR,which might lead to antibiotic resistance,is a challenging problem worldwide.A cross-sectional survey was conducted from May 1,2021,to July 15,2021,to investigate antibiotic usage by medical professionals when performing SSR in IVF centers in Vietnam.The confidential questionnaire comprised 12 items,including characteristics of the study population,awareness of antimicrobial resistance,attitude toward prescribing antibiotics,and current practice of prescribing antibiotics when performing SSR.Surveys were completed by 30 of 45 registered IVF centers(66.7%).Among 67 physicians working at those centers,the age and work-experience years(mean±standard deviation[s.d.])were 38.6±6.6 years and 11.2±7.0 years,respectively.Over 60%of them held a degree in Obstetrics and Gynecology,and over four-fifths were men.Most respondents"often/very often/always"raised awareness of antimicrobial resistance to their patients(83.3%),but only half of them"often/occasionally"prescribed antibiotics to patients with SSR in cases where the prescription would be optional.About one-tenth of respondents followed the recommendation from the American Urological Association using"prophylaxis only"for SSR patients.For more invasive SSR,physicians tended to prescribe more complicated and sometimes inappropriate regimens.In conclusion,antibiotic usage in SSR was not always appropriate among IVF centers.Further studies may define specific recommendations for regimens,intervention strategies,and programs to promote appropriate antibiotic use for SSR patients among IVF specialists.