Abstract: P-647

Non-Invasive Selection of Optimal Embryos Immediately Prior to Embryo Transfer Using Bioinfomatic Analysis of Spectral Data Following Matrix Assisted Laser Desorbtion/Ionisation Time of Flight Mass Spectrometry.Non-Invasive Selection of Optimal Embryos Immediately Prior to Embryo Transfer Using Bioinfomatic Analysis of Spectral Data Following Matrix Assisted Laser Desorbtion/Ionisation Time of Flight Mass Spectrometry.

Presenter: Stephen Butler


Abstract


OBJECTIVE: To study the direct, non-invasive analysis of spent blastocyst culture media by mass spectrometry and predict pregnancy outcomes in the minutes immediately prior to embryo transfer.
DESIGN: A prospective analysis of culture fluid collected at the time of embryo transfer compared with eventual outcomes of ongoing viable pregnancy or negative pregnancy test. view more

OBJECTIVE: To study the direct, non-invasive analysis of spent blastocyst culture media by mass spectrometry and predict pregnancy outcomes in the minutes immediately prior to embryo transfer.
DESIGN: A prospective analysis of culture fluid collected at the time of embryo transfer compared with eventual outcomes of ongoing viable pregnancy or negative pregnancy test.
MATERIALS AND METHODS: A total of 401 samples of spent blastocyst culture media were collected from embryos of at the time of transfer. 1µL of media was analyzed using MALDI ToF mass spectrometry. Quantitative characteristics within the 2000 to 12000 m/z mass range were used to generate a score and predict pregnancy outcome. Eventual outcomes were compared to spectral data derived from the culture fluid collected at this time. The predictive ability of the spectral comparison algorithms were compared to stratified Gardner Scoring in selecting good quality blastocysts that had a greater probability of identifying successful pregnancy.
RESULTS: Biochemical pregnancies and spontaneous abortion (6.2% and 6.8% of the cohort) were excluded from the final analysis. Of the remaining cohort 70% were successfully pregnant up to 13 weeks of gestation. Gardner scoring at the most optimum was only 15% more accurate at identifying outcome than chance alone (73% versus random chance accuracy of 58%). An algorithm based on comparative peak height analysis of MALDI ToF mass spectrometry of culture media was 25% more accurate than chance (83% overall accuracy in predicting outcome).
CONCLUSIONS: Although the maternal uterine environment is a contributing factor to whether an IVF cycle is successful or not, some 50-70% of failures are thought to be due to a poor quality blastocyst which fail to implant and/or develop. This is exemplified by the increased success of IVF in older women who receive blastocysts arising from donor eggs from much younger women. A simple, direct and rapid analysis of mass spectra from spent blastocysts culture media, at the point of embryo transfer, can quickly identify optimal embryos with the best chance of achieving ongoing pregnancy. Implementation of such an analysis could dramatically improve embryo selection and increase live births.

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