The Prognostic Significance of Integrated Assessment Systems for Developing Embryos (KIDScore, MitoScore): The Onset and Outcomes of Pregnancy in Cycles with PGT-A

Objective: The aim of this study is to compare the prognostic significance of the KIDScore, PGT-A, and MitoScore assessment systems in relation to the probability of embryo implantation at the blastocyst stage, pregnancy outcomes, and obstetric complications in ART cycles. Materials and Methods: The study conducted a retrospective analysis of embryological protocols and the results of PGT-A. In euploid embryos, the mitochondrial DNA MitoScore was assessed. The clinical outcomes of the resulting pregnancies were evaluated. Results: It was found that higher KIDScore values were more often determined in euploid embryos. When analyzing the relationship between KIDScore and MitoScore, no statistically significant dependence was found. However, there was a tendency towards a higher frequency of low and medium MitoScore values among embryos in groups with medium and high KIDScore values. In our study, we found a statistically unconfirmed tendency towards a higher frequency of clinical pregnancies and live births in the group of patients who underwent embryo transfer with high KIDScore and medium MitoScore values. There was an increase in the percentage of complicated pregnancies after embryo transfer with low KIDScore values. In our study, the most common obstetric complications were preeclampsia and gestational diabetes mellitus. Conclusions: The obtained data allow us to consider the cultivation of embryos using video surveillance in combination with the assessment of the implantation potential of embryos based on artificial intelligence technologies as a non-invasive tool for predicting the chromosomal status of the embryo, as well as to use this technique as an additional tool when selecting an embryo for transfer into the uterine cavity. Proper integration of the KIDScore, PGT-A, and MitoScore embryo assessment systems can help improve the accuracy of selecting an embryo with the highest potential for implantation, which is crucial for implementing a personalized approach to patients and transferring a single embryo to prevent multiple pregnancies and their associated complications.