Kirkegaard Kirstine, Ahlström Aishling, Ingerslev Hans Jakob, Hardarson Thorir
Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
IVF Lab, Reproductive Medicine, Sahlsgrenska University Hospital, Gothenberg, Sweden.
Fertil Steril. 2015 Feb;103(2):323-32. doi: 10.1016/j.fertnstert.2014.11.003. Epub 2014 Dec 17.
Within the past few years the morphological evaluation of in vitro fertilized embryos has been extended to include continuous surveillance, enabled by the introduction of time-lapse incubators developed specifically for IVF treatment. As a result time-lapse monitoring has been implemented in many clinics worldwide. The proposed benefits compared with culture in a standard incubator and fixed time-point evaluation are uninterrupted culture, a flexible workflow in the laboratory, and improved embryo selection. The latter is based on the reasonable assumption that more frequent observations will provide substantially more information on the relationship between development, timing, and embryo viability. Several retrospective studies have confirmed a relationship between time-lapse parameters and embryo viability evaluated by developmental competence, aneuploidy, and clinical pregnancy. Furthermore a much anticipated randomized study has shown improved pregnancy rates (PRs) after culture in a time-lapse incubator combined with selection using a hierarchical time-lapse selection model. At present this is the only randomized study on possible benefits of time lapse in human embryology. Strict evidence may still seem too weak to introduce time lapse in routine clinical setting. This aim of this review is therefore to perform a balanced discussion of the evidence for time-lapse monitoring.
在过去几年中，体外受精胚胎的形态学评估已扩展至包括持续监测，这得益于专门为体外受精治疗开发的延时培养箱的引入。结果，延时监测已在全球许多诊所实施。与在标准培养箱中培养和固定时间点评估相比，其预期益处包括不间断培养、实验室灵活的工作流程以及改进的胚胎选择。后者基于一个合理的假设，即更频繁的观察将提供关于发育、时间安排和胚胎活力之间关系的更多信息。几项回顾性研究证实了延时参数与通过发育能力、非整倍体和临床妊娠评估的胚胎活力之间的关系。此外，一项备受期待的随机研究表明，在延时培养箱中培养并结合使用分层延时选择模型进行选择后，妊娠率有所提高。目前，这是关于延时在人类胚胎学中可能益处的唯一一项随机研究。严格的证据可能仍显得过于薄弱，难以在常规临床环境中引入延时监测。因此，本综述的目的是对延时监测的证据进行全面的讨论。
