#79 : Triptorelin Triggered Cycles Improve Embryo Viability Compared to HCG Triggered Cycles

Abstract

Background and Aims: Embryo quality is directly related to pregnancy rate as previously demonstrated by CHLOE-EQ. CHLOE-EQ Score is an automatic embryo viability score provided by CHLOE (Fairtility). It might provide key performance indicators (KPI) to measure how different protocols impact embryo quality. KPIs are objective measures for systematically monitoring and evaluating the IVF laboratory, a critical element of every IVF clinic Quality Management System. KPIs currently rely on definitions which are simple to assess (fertilisation, cleavage, blastulation), we do not routinely use other biomarkers to monitor operations. The aim of the study was to assess how trigger protocols influence CHLOE-EQ embryo viability score. Method: Retrospective comparative analysis with 1684 time-lapse videos collected between February-June 2022 in a single private clinic. Embryos were automatically assessed by CHLOE-EQ, an AI embryologist support tool. Assessment of trigger protocol, CHLOE-EQ Score and demographic bias was measured using t-test. Results: Embryos derived from cycles triggered with Triptorelin had better quality than those triggered with HCG (CHLOE EQ Score: 3.4±4.03, n=524 vs 3.02±3.85, n=1127, p=0.03). The difference could not be explained by age, PCOS, low ovarian reserve, fibroids, polyps. However, the type of trigger did not affect embryo utilisation [250/524 (47.70% vs 485/1127(43.03%), p>0.05]. CHLOE-EQ Score is predictive of utilisation (AUC=0.88, n=1677, baseline=45%, p<0.001), blastulation (AUC=0.90, n=1681, baseline=62.2%, p<0.001) and selection for transfer (AUC=0.92, n=1677, baseline=2.7%, p<0.001). Conclusion: Triptorelin triggered cycles improve embryo viability, as measured by CHLOE-EQ automatic score, compared to HCG triggered cycles. CHLOE-EQ provides monitoring of clinical practices to determine if protocols influence clinical outcomes and KPIs. CHLOE-KPI can provide KPI insights to detect and prevent non-conformances before they get a chance to affect clinical outcome. Early prevention of operational anomalies provides an opportunity to improve standards of care.