Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, 310 Cedar street, LSOG 304D, New Haven, CT 06520-8063, USA.
J Assist Reprod Genet. 2011 Feb;28(2):137-44. doi: 10.1007/s10815-010-9501-9. Epub 2010 Nov 10.
Assessment of embryo viability is a key component of in vitro fertilization (IVF) and currently relies largely on embryo morphology and cleavage rate. In this study, we used receiver operating characteristic (ROC) analysis to compare the Viability Score (generated by metabolomic profiling of spent embryo culture media using near infrared (NIR) spectroscopy) to morphologic grading for predicting pregnancy in women undergoing single embryo transfer (SET) on day 5.
A total of 198 spent embryo culture media samples were collected in four IVF centers located in the USA, Europe and Australia. First, 137 samples (training set) were analyzed by NIR to develop an algorithm that generates a Viability Score predictive of pregnancy for each sample. Next, 61 samples (validation set) were analyzed by observers blinded to embryo morphology and IVF outcome, using the Day 5 algorithm generated with the training set. Pregnancy was defined as fetal cardiac activity (FCA) at 12 weeks of gestation.
The Area Under the Curve (AUC) was greater for the metabolomic Viability Score compared to Morphology [Training set: 0.75 versus 0.55, p = 0.0011; Validation set: 0.68 versus 0.50, P = 0.021], and for a Composite score (obtained using a model combining Viability Score with morphologic grading), compared to morphology alone [0.74 versus 0.50, p = 0.004].
Our findings suggest that Viability Score alone or in combination with morphologic grading has the potential to be a better classifier for pregnancy outcome than morphology alone in women undergoing SET on day 5.
胚胎活力评估是体外受精（IVF）的关键组成部分，目前主要依赖于胚胎形态和分裂率。在这项研究中，我们使用接受者操作特征（ROC）分析比较了活力评分（通过近红外（NIR）光谱对废弃胚胎培养物进行代谢组学分析生成）与形态学分级，以预测接受第 5 天单胚胎移植（SET）的女性的妊娠情况。
本研究共收集了来自美国、欧洲和澳大利亚的四个 IVF 中心的 198 个废弃胚胎培养物样本。首先，通过 NIR 对 137 个样本（训练集）进行分析，开发出一种算法，为每个样本生成一个预测妊娠的活力评分。然后，使用训练集生成的第 5 天算法，对 61 个样本（验证集）进行了观察者盲法分析，这些观察者对胚胎形态和 IVF 结果不知情。妊娠定义为 12 周妊娠时的胎儿心脏活动（FCA）。
与形态学相比，代谢组学活力评分的曲线下面积（AUC）更高[训练集：0.75 比 0.55，p=0.0011；验证集：0.68 比 0.50，P=0.021]，与复合评分（使用结合活力评分和形态学分级的模型获得）相比，形态学评分更高[0.74 比 0.50，p=0.004]。
我们的研究结果表明，在接受第 5 天 SET 的女性中，与单独使用形态学评分相比，活力评分单独或与形态学分级相结合具有成为更好的妊娠结局分类器的潜力。
