Department of Embryology, University of Warsaw, Miecznikowa 1, 02-096 Warsaw, Poland.
Mol Aspects Med. 2013 Oct;34(5):903-18. doi: 10.1016/j.mam.2013.03.001. Epub 2013 Apr 4.
Although in recent years we have seen an undeniable improvement in the field of reproductive biology and medicine, the efficiency of in vitro fertilization (IVF) procedures remains relatively low, ranging from 4% to 40% depending on the patient's age. It is believed that this is in a large part caused by inaccurate assessment of embryo quality prior to transfer to mothers-to-be. Thus there is a strong need for further refinement of existing selection methods and development of novel, robust and, if only possible, non-invasive procedures to ensure that only embryos with the highest developmental potential are chosen for transfer. In the present review we compare various methods for assessing the quality of preimplantation embryos either currently used in IVF clinics or still to be tested. These methods include assessment of embryonic morphology, the genetic material, the transcriptomes of the oocyte and its accompanying follicular cells, and the embryo's metabolism. We discuss what information these parameters actually provide about the processes occurring in the embryo itself. We also present novel methods for selecting healthy embryos based on most recent advanced time-lapse imaging techniques, which show great promise and are likely to lead to increased in vitro fertilization efficiency.
尽管近年来我们在生殖生物学和医学领域取得了不可否认的进展，但体外受精（IVF）程序的效率仍然相对较低，根据患者的年龄，其效率范围在 4%至 40%之间。据信，这在很大程度上是由于在将胚胎移植给准母亲之前，对胚胎质量的评估不够准确。因此，需要进一步完善现有的选择方法，并开发新的、稳健的、如果可能的话，非侵入性的程序，以确保仅选择具有最高发育潜力的胚胎进行移植。在本综述中，我们比较了目前在 IVF 诊所中使用或仍有待测试的各种评估胚胎质量的方法。这些方法包括胚胎形态评估、遗传物质、卵母细胞及其伴随的卵泡细胞的转录组以及胚胎的代谢。我们讨论了这些参数实际上提供了关于胚胎本身发生的过程的哪些信息。我们还介绍了基于最新的高级延时成像技术选择健康胚胎的新方法，这些方法显示出很大的潜力，可能会提高体外受精的效率。
