Abstract:

One of the keys to success at In Vitro Fertilization (IVF) techniques is embryo assessment, as choosing the correct embryo to transfer plays an important role in pregnancy and live birth rates. However, laboratory specialists point at the embryo assessment as one of the most challenging tasks, as it remains subjective. In fact, laboratory specialists reported low knowledge of the Istanbul consensus, which is one of the main criteria embryologists around the world follow to assess embryo quality. This can result in inaccurate evaluation.

Standardization in embryo assessment not only helps to improve laboratory rates, but also provides reliability of research results used for the development of new IVF technologies.

Therefore, we thought it necessary to develop a tool to standardize embryo assessment criteria, that would also help to identify educational needs amongst laboratory staff in order to implement training programs.

Consensus workshops are widely used in the medical, nursing and health services field as a way of overcoming subjective judgments, synthesizing information, and making decisions in groups. One of the available tools to enable this is the Delphi method which consists of three parts:
(i) first, individuals answer a questionnaire about a specific topic;
(ii) then the answers are collected and shown to the group to debate and reach a consensus;
(iii) finally, individuals answer the initial questionnaire again.

This process is repeated until the desired degree of consensus is reached. This method is currently used in a huge range of fields, and nowadays it can even be done online to enable a faster and wider reach, as well as to facilitate the process. The online variety is called e-Delphi.

In this article we describe an interactive educational tool developed for the standardization of embryo assessment criteria where embryologists evaluate different aspects of embryos based on the e-Delphi method. Participants answer an individual online questionnaire followed by an online meeting where they discuss the collected data in order to reach consensus criteria. Once the criteria has been established and implemented in the clinical practice, the questionnaire is repeated.

With this we would expect to know the interobserver variability degree in embryo assessment before and after the consensus meeting to test the efficacy of the tool and how this could possibly translate in better clinical results.

Keywords:

Standardization, Embryo Assessment, E-Delphi, Consensus, IVF.