Reducing inter-observer variability in embryo evaluation by means of training courses

To study the utility of a training session offered to junior embryologists, comparing the results obtained with those reported by a group of senior embryologists. The 62 junior embryologists participanting were asked to decide on the quality of the embryos and theg clinical decision to be taken. The junior embryologists' success rate following the training course was significantly higher than before for embryo classification (48.4% +/- 20.4 vs. 59.7% +/- 16.7) (p < 0.05) and for clinical decision (54.7% +/- 19.6 vs. 68.7% +/- 17.6) (p < 0.005). Comparison of the degree of agreement between the categories assigned by the junior embryologists and those assigned by consensus among the group of senior embryologists revealed kappa values of k = 0.32 before the course and of k = 0.54 after it. The comparison between pre- and post-training junior and senior embryologists also reflected an improvement in the kappa index for clinical decision, from k = 0.54 to k = 0.68. Training courses are shown to be an effective tool for increasing the degree of agreement between junior and senior embryologists.