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 =143 [* 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
HEF2024.01
Single Human Embryo
1/1/2024
HEF2024.02
Late day 6 Blastocyst
1/2/2024
HEF2024.03
Single Human Embryo - A
1/3/2024
HEF2024.04
Single Human Embryo
1/4/2024
HEF2024.05
Single Human Embryo 96 hr
1/5/2024
HEF2024.06
Single Human Embryo
1/6/2024
HEF2024.07
Single Human Embryo #A
1/7/2024
HEF2024.08
Single Human Embryo
1/8/2024
HEF2024.09
Single Human Embryo
1/9/2024
HEF2024.10
Single Human Embryo
1/10/2024
HEF2024.11
Single Human Embryo
1/11/2024
HEF2024.12
Single Human Embryo
1/12/2024
List
of Questions asked for QA Scheme:Blastocyst QAP - 2024
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?
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.
KEY QAP Question for the Scheme