Good practice recommendations for the use of time-lapse technology†.
Ontology highlight
ABSTRACT:
SUBMITTER: ESHRE Working group on Time-lapse technology
PROVIDER: S-EPMC7081060 | biostudies-literature | 2020
REPOSITORIES: biostudies-literature
Publications
Good practice recommendations for the use of time-lapse technology<sup>†</sup>.
Apter Susanna S Ebner Thomas T Freour Thomas T Guns Yves Y Kovacic Borut B Le Clef Nathalie N Marques Monica M Meseguer Marcos M Montjean Debbie D Sfontouris Ioannis I Sturmey Roger R Coticchio Giovanni G
Human reproduction open 20200319 2
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Project description:Study questionWhat is good practice in ultrasound (US), and more specifically during the different stages of transvaginal oocyte retrieval, based on evidence in the literature and expert opinion on US practice in ART?Summary answerThis document provides good practice recommendations covering technical aspects of US-guided transvaginal oocyte retrieval (oocyte pick up: OPU) formulated by a group of experts after considering the published data, and including the preparatory stage of OPU, the actual procedure and post-procedure care.What is known alreadyUS-guided transvaginal OPU is a widely performed procedure, but standards for best practice are not available.Study design size durationA working group (WG) collaborated on writing recommendations on the practical aspects of transvaginal OPU. A literature search for evidence of the key aspects of the procedure was carried out. Selected papers (n = 190) relevant to the topic were analyzed by the WG.Participants/materials setting methodsThe WG members considered the following key points in the papers: whether US practice standards were explained; to what extent the OPU technique was described and whether complications or incidents and how to prevent such events were reported. In the end, only 108 papers could be used to support the recommendations in this document, which focused on transvaginal OPU. Laparoscopic OPU, transabdominal OPU and OPU for IVM were outside the scope of the study.Main results and the role of chanceThere was a scarcity of studies on the actual procedural OPU technique. The document presents general recommendations for transvaginal OPU, and specific recommendations for its different stages, including prior to, during and after the procedure. Most evidence focussed on comparing different equipment (needles) and on complications and risks, including the risk of infection. For these topics, the recommendations were largely based on the results of the studies. Recommendations are provided on equipment and materials, possible risks and complications, audit and training. One of the major research gaps was training and competence. This paper has also outlined a list of research priorities (including clarification on the value or full blood count, antibiotic prophylaxis and flushing, and the need for training and proficiency).Limitations reasons for cautionThe recommendations of this paper were mostly based on clinical expertise, as at present, only a few clinical trials have focused on the oocyte retrieval techniques, and almost all available data are observational. In addition, studies focusing on OPU were heterogeneous with significant difference in techniques used, which made drafting conclusions and recommendations based on these studies even more challenging.Wider implications of the findingsThese recommendations complement previous guidelines on the management of good laboratory practice in ART. Some useful troubleshooting/checklist recommendations are given for easy implementation in clinical practice. These recommendations aim to contribute to the standardization of a rather common procedure that is still performed with great heterogeneity.Study funding/competing interestsThe meetings of the WG were funded by ESHRE. The other authors declare that they have no conflict of interest.Trial registration numberNA.ESHRE Pages content is not externally peer reviewed. The manuscript has been approved by the Executive Committee of ESHRE.
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Project description:The Discharge Medicines Review (DMR) referral system, Refer-to-Pharmacy (RTP), PharmOutcomes and Help for Harry are UK transfer of care systems that aim to reduce the risks associated with hospital discharge. These systems use technology to facilitate the transmission of discharge information to community pharmacy, allowing community pharmacists to provide an adherence-support service. Despite the evidence that these systems benefit patient safety, there is a paucity of literature on their use. This study aimed to describe, compare and contrast these systems to highlight areas that could inform good practice recommendations. A rapid literature review was completed, and from the twenty-six sources of literature that were synthesised, three themes were identified for further exploration in semi-structured interviews with key informants: implementation, system attributes and stakeholder engagement. The key informants were purposively sampled for their role in the development and/or strategic implementation of each transfer of care system (n = 4). Audio recordings were transcribed ad verbatim and analysed both deductively and inductively. One interview was undertaken for each of the DMR, RTP and PharmOutcomes systems. Although all systems shared the same aim, differences were identified such as automated feedback for referrals, marketing strategies and practitioner accountability. Good practice recommendations suggested in this study could be applied to the future development of such systems.
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Project description:Study questionWhat information and support should be offered to donors, intended parents and donor-conceived people, in general and in consideration of the availability of direct-to-consumer genetic testing and matching services?Summary answerFor donors, intended parents and donor-conceived offspring, recommendations are made that cover information needs and informed consent, psychosocial implications and disclosure.What is known alreadyTrends indicate that the use of donor-assisted conception is growing and guidance is needed to help these recipients/intended parents, the donors and offspring, navigate the rapidly changing environment in which donor-assisted conception takes place.Study design size durationA working group (WG) collaborated on writing recommendations based, where available, on evidence collected from a literature search and expert opinion. Draft recommendations were published for stakeholder review and adapted where relevant based on the comments received.Participants/materials setting methodsPapers retrieved from PUBMED were included from 1 January 2014 up to 31 August 2020, focusing on studies published since direct-to-consumer genetic testing has become more widespread and accessible. The current paper is limited to reproductive donation performed in medically assisted reproduction (MAR) centres (and gamete banks): donation outside the medical context was not considered.Main results and the role of chanceIn total, 32 recommendations were made for information provision and support to donors, 32 for intended parents and 27 for donor-conceived offspring requesting information/support.Limitations reasons for cautionThe available evidence in the area of reproductive donation is limited and diverse with regards to the context and types of donation. General conclusions and recommendations are largely based on expert opinion and may need to be adapted in light of future research.Wider implications of the findingsThese recommendations provide guidance to MAR centres and gamete banks on good practice in information provision and support but should also be considered by regulatory bodies and policymakers at a national and international level to guide regulatory and legislative efforts towards the protection of donors and donor-conceived offspring.Study funding/competing interestsThe development of this good practice paper was funded by European Society of Human Reproduction and Embryology (ESHRE), covering expenses associated with the WG meetings, the literature searches and dissemination. The WG members did not receive any payment. The authors have no conflicts of interest to declare.DisclaimerThis document represents the views of ESHRE, which are the result of consensus between the relevant ESHRE stakeholders and where relevant based on the scientific evidence available at the time of preparation. The recommendations should be used for informational and educational purposes. They should not be interpreted as setting a standard of care, or be deemed inclusive of all proper methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results. They do not replace the need for application of clinical judgement to each individual presentation, nor variations based on locality and facility type. †ESHRE pages content is not externally peer reviewed. The manuscript has been approved by the Executive Committee of ESHRE.
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Project description:BackgroundTime-lapse technology (TLT) has emerged as a significant advancement in the field of assisted reproductive technology (ART), providing continuous observation of embryos. However, limited information exists on the adoption of TLT across ART facilities and the clinical implications of its application in embryo evaluation and fertilization verification. The existing literature has not yet comprehensively examined how TLT data are utilized to optimize ART outcomes, particularly in Japan, where ART practices are highly prevalent.ObjectivesThis study aimed to investigate the adoption rate of TLT and its clinical effects on fertilization verification, embryo evaluation, and utilization of ART in Japan.Study designAn online survey was conducted from December 23, 2022, to January 16, 2023, in 616 ART facilities with both email and mailed notices. The survey investigated the utilization of TLT in each facility's evaluation of oocyte morphology, fertilization, embryo culture, and morphology.ResultsOverall, 345 responses were analyzed. Of these, only 42.6% confirmed fertilization at 16 to 18 hours after insemination. Most facilities defined normally fertilized eggs as 2 pronuclei (2PN; 53.3%) or a combination of a second polar body extrusion and 2PN (44.9%). Overall, 54.6% of the facilities had adopted TLT, and 76.9% to 96.9% of these facilities used TLT images for fertilization verification. At these centers, the use of 0PN embryos decreased, whereas the use of 2.1PN embryos increased. The rates of culture medium supplemented with antioxidants and hyaluronan were significantly higher in facilities with TLT than in those without TLT. TLT images were used for embryo evaluation in 94.3% of the facilities, while 31.0% used a combination of TLT images and artificial intelligence-based scoring systems.ConclusionsWhile TLT use is widespread in Japan, its application in evaluating fertilization and embryo development stages varies across facilities. Reaching a consensus on the optimal use of the TLT system will enhance the effectiveness, safety, and efficiency of ARTs.
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