Footage of two Day 5/6 human blastocysts are recorded and sent to labs for assessment. The blastocysts are recorded whilst in culture medium microdroplets under oil at 37°C. The blastocysts are manipulated and rolled using micropipettes in order to facilitate adequate visualisation of the trophectoderm and inner cell mass. Responses to questions regarding the quality of the TE and ICM for each blastocyst are required as well as their suitability for transfer and or freezing.
Direct antisperm antibody assessment (footage)
This module provides an appropriate complement or alternative to the serum based "Indirect Anti-sperm Antibody Testing Scheme". Whilst the testing of serum samples for the presence of Anti-sperm Antibodies is still regarded as an important part of the assessment of an infertile couple, it's methodology differs from that used to test for sperm antibodies in semen. For this reason it is not feasible to send semen samples for determination of Anti-sperm antibody levels. This scheme provides footage of sperm/bead interactions in a similar fashion to our Sperm Motility Scheme, allowing users to view the footage and assess the percentage of motile sperm bound to beads. As with the other schemes, labs are asked to determine if the level of binding is "of clinical significance" based on the standards set by the WHO laboratory manual for the examination of human semen sperm-cervical mucus interactions 5th ed. Please note that binding restricted to the tail tip is not associated with impaired fertility and therefore users are asked to exclude this type of binding from their assessments.
Footage of four Day 2/3 human embryos are recorded and sent to labs for assessment. The embryos are recorded whilst in culture medium microdroplets under oil at 37°C. The embryos are rolled using micropipettes in order to facilitate appropriate morphological assessment. Labs are asked to grade the embryo and count the number of viable cells present. Responses to questions relating to each individual embryo, its quality and suitability for freeze or transfer may also be required. This is done to compare how different laboratories assess their embryos and determine what their fate would be.
This scheme has been designed for users of time-lapse monitoring incubators. Time-lapse assessment of embryo morphokinetics is showing immense potential as an effective tool to identify embryos with higher implantation potential or as a de-selection tool for embryos displaying morphokinetic events associated with significantly lower rates of implantation such as direct cleavage (Rubio et al 2012) or abnormal syngamy (Wirka et al 2014). Embryo mophokinetic behaviour has also been shown to be associated with aneuploidy status (Campbell et al 2013).
Accurate determination and identification of cellular and developmental events is crucial for time-lapse imaging users. Currently there is limited data on within and between laboratory variability in this field. Participation in our "Embryo time-lapse" scheme would be of great benefit to users of this system for not only peer comparison but also for within lab monitoring using the IQC module.
Complete video footage from insemination to Day 5 or 6 of development for 2 embryos is sent on USB to participating labs. Video resolution is such that individual morphokinetic events can be identified easily using the pause/play function on Windows Media Player.
Three questions relating to specific timing of events requiring a numerical response are asked and statistics are performed on all results received. An additional three qualitative questions per embryo are also posed and these are summarised in tally form.
Click here to view the definition of morphokinetic events.
The assessment of sperm DNA fragmentation may be included as part of routine semen analysis but could be especially important for couples seeking fertility treatment. This scheme is designed for those laboratories assessing sperm DNA fragmentation using the Halosperm G2 assay, a method based upon the Sperm Chromatin Dispersion test. Each distribution contains video footage of slides prepared from 4 semen samples, with the footage showing the views seen using a brightfield microscope. Laboratories will be asked to determine proportion of sperm with DNA fragmentation according to their routine criteria, and whether the result was within the laboratory’s reference range. These DVD’s can be retained for your staff training and IQC exercises and results can also be entered into the EQASRM Internal QC module.
It would not be possible to send ‘live’ semen samples to labs given factors such as delays in transportation and temperature maintenance. Therefore, EQASRM sends out footage of semen samples recorded during microscopic evaluation. Recordings of four samples are done at 37C°, using an inverted or phase contrast microscope. Six fields of view per sample are recorded, each lasting approximately 20-25 seconds. Labs are asked to report the motility of each sample using the WHO 5th edition, 3 category system. This is so results can be standardized and appropriately compared with others.
The Sperm-Hyaluronan Binding Assay is a diagnostic tool used by labs as part of their male fertility investigations to aid in the assessment of sperm quality, maturity and fertilizing potential. It works on the principle that mature sperm express Hyaluronan receptors and will bind to hyaluronan coated slides. The test may be of assistance when deciding the most appropriate treatment for patients.
The EQASRM Hyaluronan Binding Assay Scheme is a digital based scheme. Each distribution, footage of 4 semen samples that have been loaded onto a HBA slide ® (Origio) is sent to participating labs. Labs are asked to report the percentage of motile sperm bound to the slide, relative to unbound motile sperm. Immotile sperm should not be included in the assessment. Labs are also asked to comment on the clinical significance of their finding. The scheme also has the added benefit of our Internal QC module and MU calculator. Laboratories routinely using the PICSI dish in their ICSI procedures would also benefit from participation in this scheme as the same principle is used with these dishes.