P-272 The impact of CHLOE-EQ and embryologist seniority on the ability and confidence to predict ploidy

Abstract Study question Can embryologists and CHLOE-EQ predict ploidy? Does their confidence ability to vary with embryologist seniority? Summary answer High inter-observer variability between on prediction of ploidy. provided a consistent What is known already Previous studies have demonstrated the value using Artificial Intelligence (AI)-based tools, such as (Fairtility), support, quantify standardize embryo assessment. uses AI-based algorithms implantation. Recent that also ploidy predictive capabilities. Little about human blastocysts deemed suitable for biopsy, whether this varies seniority or level. design, size, duration Cohort study including 141 patients treated in Memorial Sisli Hospital ART Reproductive Genetics Center January 2020-August 2022, at least 4 different PGT-A results per cycle, leading total 734 embryos. The same were blindly assessed by senior junior working clinic. Intraobserver variance was evaluated. Participants/materials, setting, methods Embryologists asked blastocyst euploid aneuploid, determination (confident, neutral, not confident), rank embryos based chance being euploid. CHLOE-EQ, scoring from 0 10. extent mosaicism (from 35-70%) quantified. Trophectoderm biopsy performed 3BB, four low quality (Aneuploid:5AC,4AC,6CB; Euploid:2AA) included into study. Main role average patient age 33 ± years (ranging 22 39 years). agreed minority blastocysts(48%,324/670). Agreement time higher (Kappa = 0.42, moderate) than [Kappa 0.19(slight)/0.26(fair)], suggesting affected consistency. ranking had fair agreement 0.22,0.22,0.23), bringing consistency irrespective seniority. Confidence (senior vs junior: ‘Confident’/’Neutral’/’Not confident’:60/26/14% 57/27/16% 66/24/10%,NS). Efficacy reduced (senior: AUC 0.58,0.57 junior:AUC 0.55). able greater accuracy when ‘confident’ (AUC 0.60, n 441, p<0.001) compared ‘not confident’ 0.50, 107, NS). This case (‘Confident’ 0.56,NS ‘Not Confident’ 0.54,NS). Euploidy rate high embryos(CHLOE-EQ 5.1-10) low(0-5) (60%, 272/457 48%,135/280;p<0.005,AUC 0.58). maintained where ‘confident’(64% 54%) (57% 36%), showing assessment confidence. score increasing degree (Euploid 6.3 2; Mosaic<35% 5.98 2.87; Mosaic>50% 4.31 2.80; Mosaic>70% 2.85 4;p 0.04). Euploid aneuploid/mosaic (6.3 2, 396 5.78 2,n 319;p 0.008). Limitations, reasons caution Mostly optimal There need better understand improving selection extend viable lower be rather discarded. Wider implications findings Effective can (i) improve criteria so are discarded, (ii) reduce cost prioritizing increased chances CHLOE-EQ’s improved support both programs, cycles an option. Trial registration number Not applicable