Studying the IVF Laboratory Performance Indicators According to the Vienna Consensus 2017 for the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Iraq

Abstract

Background: Performance indicators are used to assess patient safety, efficacy, equity, patient-centeredness, punctuality, and efficiency. The benchmark values for each Key Performance Indicator are aspirational values, and the minimum performance level values are the number of fertilized oocytes on Day 1 and the Normal Fertilization Rate, respectively (presence of 2Pro Nucleus and 2Polar Body measured at 17 h post-injection) as a Failed fertilization rate is calculated as the proportion of IVF cycles (excluding cycles with intracytoplasmic injection) on Day 1 (17 hours after insemination) with no signs of pregnancy. During fertilization (i.e., 0 oocytes with 2Pro Nucleus). The percentage of zygotes on Day 2 (44 hours after insemination) is known as the cleavage rate, and it can suggest an issue with sperm quality (sperm function, oocyte activation, and gamete receptors), sperm processing, or the quantity of spermatozoa used for insemination. which cleaves to create embryos. The percentage of cleaved embryos per successfully fertilized egg that are at the 4-cell stage on Day 2 (44 hours post-insemination) or at the 8-cell stage on Day 3 (68 hours post-insemination) is known as the embryo development rate. This evaluates the viability and quality of the embryos as well as the capacity of the culture system to promote cleavage at the necessary stages. The critical factor is the proportion of blastocysts observed at 116 hours after insemination as a function of the number of correctly fertilized oocytes. Measures of performance blastocyst development rate. The viability of the embryo as well as the culture system's capacity to support blastocyst formation from fertilized oocytes (i.e., the formation of an intracellular mass and a blastocoele cavity) are both determined by this factor. It should be noted that this phrase only considers blastocyst formation and not blastocyst stage or quality. The damage rate is the proportion of oocytes that are injured or have deteriorated by the time of fertilization assessment on Day 1 as a result of the intracytoplasmic injection. The percentage of biopsied and tubed/fixed samples where DNA is found represents the success rate of the biopsy. It serves as a gauge of the embryologists' ability to transfer biopsied samples to test tubes, as shown by successful DNA amplification. The number of gestational sacs divided by the total number of transplanted embryos is how one calculates the implantation rate, which is dependent on the cleavage stage. By dividing the number of gestational sacs by the total number of transplanted blastocysts, the implantation KPI (blastocyst stage) is calculated.AimCompare the annual results of our institute with the ESHRE-defined international KPI, the Performance Indicators (Fertilization rate, cleavage rate, development day 2, development day 3, blastocyst rate, blastocyst cryosurvival rate, damage rate, successful biopsy rate, implantation rate depends on cleavage stage, implantation rate depends on blastocyst stage).Patients and Methods: From November 2015 to December 2021, 699 infertile couples who were having intracytoplasmic sperm injection were included in a retrospective study done at the high institution for infertility diagnosis and assisted reproductive technologies at Al Nahrain University in Baghdad, Iraq. The information gathered from the lab and the archive room was classified and divided. Comparing each year to the previous years as well as comparing with the performance indicators (fertilization rate, cleavage rate, development day 2, development day 3, blastocyst rate, blastocyst cryosurvival rate, damage rate, success rate of biopsy, implantation rate dependent on cleavage stage, implantation rate dependent on blastocyst stage), as well as with ESHRE. Except for the successful biopsy rate and implantation rate, all markers were identified in this investigation.ResultsThe fertilization and cleavage rates closely to ESHRE's Key Performance Indicators. The outcomes from days two and three were also close to the ESHRE competency and benchmark standards. Comparison of the mean blastocyst rate revealed a substantial amount of fluctuation, with the highest year being 2016 and the lowest being 2019. 2015 and 2016 are the highest and lowest years for a blastocyst of cryosurvival, respectively. 2020 and 2021 both saw the highest ICSI damage rate. 2015 and 2020 are the highest and lowest pregnancy result years respectively.

Keywords

KPI, ICSI, Pregnancy rate