• Christina Anagnostopoulou, Israel Maldonado Rosas, Neha Singh, Nivita Gugnani, Annapoorani Chockalingham, Keerti Singh, Dimple Desai, Mahsa Darbandi, Madhumitha Manoharan, Sara Darbandi, Sofia I Leonardi Diaz, Sajal Gupta, Ralf Henkel, Hassan N Sallam, Florence Boitrelle, Kelly A Wirka, and Ashok Agarwal.
• Unit Reproductive Medicine, Embryo ART, Lito Maternity Hospital, Athens, Greece.
• Panminerva Med. 2022 Jun 1; 64 (2): 171-184.

AbstractWith the advance of assisted reproduction techniques, and the trend towards blastocyst culture and single embryo transfer, gamete and embryo assessment have gained greater importance in ART treatment. Embryo quality depends mainly on gamete quality and culture conditions. Oocyte maturity identification is necessary in order to plan fertilization timing. Mature oocytes at the metaphase II stage show a higher fertilization rate compared to immature oocytes. Morphology assessment is a critical yet challenging task that may serve as a good prognostic tool for future development and implantation potential if done effectively. Various grading systems have been suggested to assess embryos at pronuclear, cleavage, and blastocyst stages. By identifying the embryo with the highest implantation potential, it is possible to reduce the number of embryos transferred without compromising the chances of a successful pregnancy. Apart from the conventional morphology assessment, there are several invasive or non-invasive methods for embryo selection such as preimplantation genetic testing, morphokinetics, proteomics, metabolomics, oxygen consumption, and measurement of oxidative stress in culture medium. Morphokinetics is a method based on time-lapse technology and continuous monitoring of embryos. In this review, we aimed to describe and compare the most effective and widely used methods for gamete and embryo assessment as well as embryo selection.

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