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[植入前胚胎发育:临床胚胎学的现状与展望]

[Preimplantation embryo development: current status and perspectives in clinical embryology].

作者信息

Royère D, Guérif F

机构信息

UMR 6175, physiologie de la reproduction et des comportements, médecine foetale et reproduction humaine, service de médecine et biologie de la reproduction, CHRU Bretonneau, 37044 Tours cedex, France.

出版信息

Gynecol Obstet Fertil. 2008 Nov;36(11):1119-25. doi: 10.1016/j.gyobfe.2008.08.009. Epub 2008 Oct 18.

DOI:10.1016/j.gyobfe.2008.08.009
PMID:18930692
Abstract

Preimplantation embryo development is one of the key features with implantation itself to achieve a pregnancy. Assisted Reproductive Technologies (ART) both in human and animal have improved our knowledge on these events, although predicting embryo potential to give a baby remains elusive. However data from the last 10 years have allowed either to hierarchize the available parameters or to open some new perspectives to predict embryo developmental potential. Both kinetics and morphological parameters belong to noninvasive quality embryo assessment for many years, although recent data on microvideographic analysis and multivariate analysis led to reduce their biological meaning. Moreover, new technical detection of meiotic spindle birefringency or zona pellucida anisotropy has improved the oocyte quality assessment with a deep impact for countries with restrictive legislation. Beyond such morphological criteria, more functional approaches concerned the oocyte (embryo) or its environment. Direct transcriptomic analysis, while invasive and therefore experimental, brought important data on embryo "quality". However, noninvasive metabolomic or proteomic analysis of embryo media gave promising results as well as respirometry. The environment of the oocyte has focused a specific attention, either based on regulatory proteins or cytokines present in follicular fluid, or involving genes or proteins from cumulus cells, as oocyte-cumulus dialog is a key factor in oocyte maturation. Whereas it is not possible for the time being to predict which parameter(s) will be implemented routinely, all data obtained underline that the ability to develop and implant is not based on embryo superlatives (more rapid, expressing more genes or proteins, larger metabolites uptake) but rather on a quiet state, as claimed by Leese some years ago, where a lot of resources would not be mobilized by any stressful situation.

摘要

植入前胚胎发育是实现妊娠的关键特征之一,与植入过程本身密切相关。人类和动物的辅助生殖技术(ART)增进了我们对这些过程的了解,尽管预测胚胎发育成婴儿的潜力仍然困难重重。然而,过去十年的数据使我们能够对现有参数进行分级,或为预测胚胎发育潜力开辟一些新的视角。多年来,动力学和形态学参数都属于无创性胚胎质量评估指标,尽管最近关于显微摄像分析和多变量分析的数据降低了它们的生物学意义。此外,减数分裂纺锤体双折射或透明带各向异性的新技术检测改善了卵母细胞质量评估,对立法严格的国家产生了深远影响。除了这些形态学标准外,更多的功能学方法涉及卵母细胞(胚胎)或其环境。直接转录组分析虽然具有侵入性,因此属于实验性方法,但它带来了关于胚胎“质量”的重要数据。然而,对胚胎培养液进行的非侵入性代谢组学或蛋白质组学分析以及呼吸测定法也取得了有前景的结果。卵母细胞的环境受到了特别关注,这既基于卵泡液中存在的调节蛋白或细胞因子,也涉及卵丘细胞的基因或蛋白质,因为卵母细胞 - 卵丘细胞对话是卵母细胞成熟的关键因素。虽然目前还无法预测哪些参数将被常规应用,但所获得的所有数据都表明,发育和植入的能力并非基于胚胎的优势(发育更快、表达更多基因或蛋白质、摄取更多代谢物),而是基于一种安静的状态,正如Leese几年前所声称的那样,在这种状态下,任何应激情况都不会调动大量资源。

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