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Reducing inter-observer variability in embryo evaluation by means of training courses

  • ASSISTED REPRODUCTION TECHNOLOGIES
  • Published:
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Abstract

Purpose

To study the utility of a training session offered to junior embryologists, comparing the results obtained with those reported by a group of senior embryologists.

Methods

The 62 junior embryologists participanting were asked to decide on the quality of the embryos and theg clinical decision to be taken.

Results

The junior embryologists’ success rate following the training course was significantly higher than before for embryo classification (48.4% ± 20.4 vs. 59.7% ±16.7) (p < 0.05) and for clinical decision (54.7% ± 19.6 vs. 68.7% ± 17.6) (p < 0.005). Comparison of the degree of agreement between the categories assigned by the junior embryologists and those assigned by consensus among the group of senior embryologists revealed kappa values of k = 0.32 before the course and of k = 0.54 after it. The comparison between pre- and post-training junior and senior embryologists also reflected an improvement in the kappa index for clinical decision, from k = 0.54 to k = 0.68.

Conclusions

Training courses are shown to be an effective tool for increasing the degree of agreement between junior and senior embryologists.

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References

  1. Sharpe-Timms KL, Zimmer RL. Oocyte and pre-embryo classification. In: Kal BA, May JV, De Jonge CI, editors. Handbook of the assisted reproduction laboratory. 1st ed. USA: CRC; 2000. p. 179–96.

    Google Scholar 

  2. Fisch JD, Rodriguez H, Ross R, Overby G, Sher G. The graduated embryo score (GES) predicts blastocyst formation and pregnancy rate from cleavage-stage embryos. Hum Reprod. 2001;16:1970–5.

    Article  PubMed  CAS  Google Scholar 

  3. De Placido G, Wilding M, Strina I, Alviggi E, Alviggi C, Mollo A, et al. High outcome predictability alter IVF using a combined store for zygote and embryo morphology and growth rate. Hum Reprod. 2002;17:2402–9.

    Article  PubMed  Google Scholar 

  4. Holte J, Berglund L, Milton K, Garello C, Gennarelli G, Revelli A, et al. Construction of an evidence-based integrated morphology cleavage embryo score for implantation potential of embryos scored and transferred on day 2 after oocyte retrieval. Hum Reprod. 2007;22:548–57.

    Article  PubMed  CAS  Google Scholar 

  5. Keck C, Fischer R, Baukloh V, Alper M. Quality management in reproductive medicine. In: Gadner DK, Weissman A, Howles CM, Shohan Z, editors. Textbook of assisted reproductive techniques. Laboratory and clinical perspectives. 2nd ed. London and New York: Taylor and Francis; 2004. p. 477–94.

    Google Scholar 

  6. Arce JC, Ziebe S, Lundin K, Janssens R, Helmgaard L, Sorensen P. Interobserver agreement and intraobserver reproducibility of embryo quality assessments. Hum Reprod. 2006;21:2141–8.

    Article  PubMed  Google Scholar 

  7. Baxter AE, Mayer JF, Shipley SK, Catherino WH. Interobserver and intraobserver variation in day 3 embryo grading. Fértil Steril. 2006;86:1608–15.

    Article  Google Scholar 

  8. Matson PL. Internal and external quality assurance in the IVF laboratory. Hum Reprod. 1998;13:156–65.

    PubMed  Google Scholar 

  9. Castilla JA, Ruiz de Assín R, Gonzalvo MC, Clavero A, Ramírez JP, Vergara F, et al. External quality control for embryology laboratory. RBMOnline. 2010;20:68–74.

    Google Scholar 

  10. Ruiz de Assín R, Clavero A, Gonzalvo MC, Ramírez JP, Zamora S, Fernández A, et al. Comparison of methods to determine the assigned value in an external quality control programme for embryo evaluation. RBM Online. 2009;19:824–9.

    PubMed  Google Scholar 

  11. The Practice Committee of the American Society for Reproductive Medicine and the Practice Committee of the Society for Assisted Reproductive Technology. Revised guidelines for human embryology and andrology laboratories. Fertil Steril. 2006;86(Suppl 4):57–72.

    Google Scholar 

  12. ASEBIR. Criterios de valoración morfológicos de oocitos, embriones tempranos y blastocistos humanos. II Cuaderno de Embriología Clínica. 2008 (www.asebir.com/…/cuadernos…/ii-cuadernos-de-embriología-clínica).

  13. Castilla JA, Ortiz A, Magán R, Ortiz-Galisteo JR, González E, Aguilar J, et al. Resultados de un ensayo piloto para un Programa Nacional de Control de Calidad Externo de Laboratorio de FIV. ASEBIR. 2003;8:40–5.

    Google Scholar 

  14. Desai NN, Goldstein J, Rowland DY, Goldfarb JM. Morphological evaluation of human embryos and derivation of an embryo quality scoring system specific for day 3 embryos: a preliminary study. Hum Reprod. 2000;15:2190–6.

    Article  PubMed  CAS  Google Scholar 

  15. Björndahl L, Barratt CLR, Fraser LR, Kvist U, Mortimer D. ESHRE basic semen analysis courses 1995–1999: immediate beneficial effects of standardized training. Hum Reprod. 2002;17:1299–305.

    Article  PubMed  Google Scholar 

  16. Franken DR, Kruger TF. Lessons learned from a sperm morphology quality control programme. Andrología. 2006;38:225–9.

    Article  PubMed  CAS  Google Scholar 

  17. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.

    Article  PubMed  CAS  Google Scholar 

  18. Ali J, Adam R, Pierre I, Bedaysie H, Josa D, Winn J. Comparison of performance 2 years after the old and new (interactive) ATLS courses. J Surg Res. 2001;97:71–5.

    Article  PubMed  CAS  Google Scholar 

  19. Ali J, Adam RU, Sammy I, Ali E, Williams JI. The simulated trauma patient teaching module-does it improve student performance? J Trauma. 2007;62:1416–20.

    Article  PubMed  Google Scholar 

  20. Dessolle L, Biau DJ, Larouzière V, Ravel C, Antoine J-M, Deraí E, et al. Learning curve of vitrification assessed by cumulative summation test for learning curve (LC-CUSUM). Fertil Steril. 2009;92:943–5.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors of this study thank the members of the embryo quality working group of the Spanish Association for the Study of Reproductive Biology (ASEBIR)—Manuel Ardoy (U Reproducción, Hospital Gregorio Marañón, Madrid), Jorge Cuadros (FIV Madrid, Madrid), María José Torelló (Clínica Quirón, Barcelona), Gema Arroyo (IU Dexeus, Barcelona) and Luz Rodríguez (Fundación Jiménez Díaz, Madrid)—for the confidence placed in the authors and for their cooperation with this work, without which this study could not have been made. In addition, we thank the coordinators of the training courses held in Barcelona (Montse Boada and Mark Grossman), Madrid (Jorge Cuadros and Manuel Ardoy) and Sevilla (Victoria Hurtado de Mendoza).

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Authors and Affiliations

  1. Unidad de Reproducción Humana, Hospital Universitario “Virgen de las Nieves”, Granada, Spain

    Rafael Ruiz de Assin, Ana Clavero, Maria Carmen Gonzalvo, Antonio Rosales, Sandra Zamora, Luis Martinez, Juan Mozas & Jose Antonio Castilla

  2. Banco de Semen CEIFER, Granada, Spain

    Jose Antonio Castilla

  3. Programa de Control de Calidad Externo para el Laboratorio de Reproducción de la Asociación para el Estudio de la Biología de la Reproducción (ASEBIR), Madrid, Spain

    Jose Antonio Castilla

  4. Departamento de Obstetricia y Ginecología, Universidad de Granada, Granada, Spain

    Juan Mozas

  5. Unidad de Reproducción, C/ Dr. Azpitarte. Edificio de consultas externas. Hospital Materno-Infantil, Granada, 18014, Spain

    Juan Mozas

Authors
  1. Rafael Ruiz de Assin
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  2. Ana Clavero
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  3. Maria Carmen Gonzalvo
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  4. Antonio Rosales
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  5. Sandra Zamora
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  6. Luis Martinez
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  7. Juan Mozas
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  8. Jose Antonio Castilla
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Corresponding author

Correspondence to Juan Mozas.

Additional information

Capsule

Training courses are shown to be an effective tool for increasing the degree of agrement between junior and senior embryologists.

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Ruiz de Assin, R., Clavero, A., Gonzalvo, M.C. et al. Reducing inter-observer variability in embryo evaluation by means of training courses. J Assist Reprod Genet 28, 1129–1133 (2011). https://doi.org/10.1007/s10815-011-9639-0

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  • DOI: https://doi.org/10.1007/s10815-011-9639-0

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