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DISCPLINES: Embryology Andrology Ultrasound Endocrinology
Modules HEB HEC HEE HEF HER HES HET HOva
 
Information on QA Scheme: Blastocyst QAP - 2019
Comment = Images of day 5 human embryos for QAP purposes. The images are all animated gif files of multiple embryo images. The primary question used for quality assessments, the QAP question has been modified from 2003 with the introduction of a calculated embryo scrore parameter [ESP]. This allows for the assessment to be based upon the common criteria embryologists used in their daily embryo grading. The sum of each parameter leads to a calculated value that is submitted for assessment and comparison. The multiple images (3-4 animated images) is used to assess comparative judgements for both transfer and for freezing. A text based summary has been included allowing participants to review how others describe and guage embryos. While the replies to all questions can be probed from conformity, the QAP question forms the basis for internal quality control and for external comparison for both each staff member and for the clinic overall. A new question has been added to explore one capacity to identify the inner cell mass.
Number of enrollments =265 [* This indicates only the number of enrollments. Not all participants will have completed the scheme]
List of QA Issues (or Instalments)
Code Title Available from
HEF2019.01 Single Human Embryo 1/1/2019
HEF2019.02 Late day 6 Blastocyst 1/2/2019
HEF2019.03 Single Human Embryo - A 1/3/2019
HEF2019.04 Single Human Embryo 1/4/2019
HEF2019.05 Single Human Embryo 96 hr 1/5/2019
HEF2019.06 Single Human Embryo 1/6/2019
HEF2019.07 Single Human Embryo #A 1/7/2019
HEF2019.08 Single Human Embryo 1/8/2019
HEF2019.09 Single Human Embryo 1/9/2019
HEF2019.10 Single Human Embryo 1/10/2019
HEF2019.11 Single Human Embryo 1/11/2019
HEF2019.12 Single Human Embryo 1/12/2019
List of Questions asked for QA Scheme:Blastocyst QAP - 2019
ID Question Question Format
11 Describe the appearance of the inner cell mass Defined Options
12 Describe the appearance of the trophectoderm Defined Options
202 How would you describe this embryo AND GRADE BY YOUR OWN CLINICS GRADING PROCESS? Educational Outcome
393 Identify the location of the inner cell mass. Defined Options
28 Is the rate of cleavage normal? Defined Options
589 This is a QA question. Would you consider the list of questions asked to assess a blastocyst sufficient? If not what further questions would you like to see asked and included in the formulation? Educational Outcome
210 What is the embryo score for this blastocyst Calculation Outcome
13 What stage of blastocyst formation is evident from the image? Defined Options
This question has been used in the following computations. - See Calculated Q for more details
Blastocyst Score-Ver 1
Detailed Information on Question: What is the embryo score for this blastocyst
Status This is the KEY QAP Question for the Scheme    
Type Calculation Outcome
Order Question Options
1 The calculated score for this embryo is

Title Blastocyst Score-Ver 1
Comment This score calculates a blastocyst value from the Gardners Grading Scheme
This is a calculated Question. It requires a number of other questions to be completed. The answer to these questions have each been weighted (see below). The value submitted for each question is then compiled as detailed below to provide a SCORE usually out of 100. The higher the score usually indicates a better quality. The score is an arbitary one and has been generated within QAPonline to allow all the parameters embodies in the questions to be assess.
Order Question
Calculation
Summation
1 What stage of blastocyst formation is evident from the image?
Value *4
+
2 Describe the appearance of the inner cell mass
Value *4
+
3 Describe the appearance of the trophectoderm
Value *4
+
4 Is the rate of cleavage normal?
Value *4
+

1 What stage of blastocyst formation is evident from the image?
Order Option
Value
Max value
1 Hatched blastocyst (Gardners Scale 6) [91-100]
10
10
2 Hatching Blastocyst (Gardners Scale 5) [81-90]
9
10
3 Expanded Blastocyst: The blastocoel appears expanded (Gardners Scale 4) [71-80]
8
10
4 Full Blastocyst: The blastocoel is fully developed (Gardners Scale 3) [61-70]
7
10
5 Blastocyst: The blastocoel is more than half the embryo volume (Gardners Scale 2) [51-60]
6
10
6 Early blastocyst: The blastocoel is less than half the embryo volume (Gardners Scale 1) [41-50]
5
10
7 There is no blastocoel evident- fully compacted. [31-40]
4
10
8 Loosley compacted morula [21-30]
3
10
9 Multicellular embryo with early compaction events [11-20]
2
10
10 Arrested, delayed or abnormal development- [1-10]
1
10

2 Describe the appearance of the inner cell mass
Order Option
Value
Max value
1 Inner Cell Mass is tightly packed with many cells (Gardners Scale A)
5
5
2 Inner Cell Mass is loosely packed with several cells (Gardners Scale B)
4
5
3 Inner Cell Mass has very few cells (Gardners Scale C)
3
5
4 The inner cell mass is not visible or not formed.
2
5
5 The inner cell mass is abnormal
1
5

3 Describe the appearance of the trophectoderm
Order Option
Value
Max value
1 Trophectoderm Grade is Good -many cells forming a cohesive epithelium (Gardners Scale A)
5
5
2 Trophectoderm Grade is Average - few cells forming a loose epithelium (Gardners Scale B)
4
5
3 Trophectoderm Grade is Poor - very few large cells(Gardners Scale C)
3
5
4 There is no trophectoderm visible
2
5
5 The trophectoderm is abnormal
1
5

4 Is the rate of cleavage normal?
Order Option
Value
Max value
1 YES, this embryo is normal.
1
1
2 No - this embryo has cleaved or developed faster than expected.
0.75
1
3 No, the embryo is delayed.
0.5
1
4 No, the embryo has arrested or significantly delayed.
0.25
1
5 No, the embryo is abnormal.
0.1
1


 
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