Milewski Robert, Kuć Paweł, Kuczyńska Agnieszka, Stankiewicz Bożena, Łukaszuk Krzysztof, Kuczyński Waldemar
Department of Statistics and Medical Informatics, Medical University of Bialystok, Szpitalna 37, 15-295, Bialystok, Poland,
J Assist Reprod Genet. 2015 Apr;32(4):571-9. doi: 10.1007/s10815-015-0440-3. Epub 2015 Feb 18.
The aim of the study was to create a predictive model of blastocyst development based on morphokinetic parameters of time-lapse embryoscope monitoring.
Time-lapse recordings of 432 embryos (obtained from 77 patients), monitored in Embryoscope, were involved in the study. Patients underwent in vitro fertilization according to standard procedure between June 2012 and April 2013. A retrospective analysis of morphokinetic features, focused on duration of time from the Intracytoplasmic Sperm Injection (ICSI) procedure to consecutive embryo division for 2, 3, 4 and 5 blastomeres, as well as time intervals between each division, was conducted. All embryos were observed for 5 days.
Based on the distribution of analyzed morphokinetic parameters and number of embryos developed to blastocyst, a range denoting the possibility of an embryo reaching blastocyst stage was determined. According to the obtained results, univariate and multivariate logistic regression analyses were performed. Based on the times of division for two and five blastomeres and intervals between the second and third division, a multivariate predictive model was created. The predictive equation was constructed based on the parameters of logistic regression analysis (odds ratios). Statistically significant differences (p < 0.001) in the size of the prediction parameter between the group of embryos developed to blastocyst (the median value: Me = 9.95, and quartiles: Q1 = 7.59, Q3 = 12.30) and embryos that did not develop to the blastocyst stage (Me = 4.66, Q1 = 2.33, Q3 = 8.19) were found. A Receiver Operating Characteristic (ROC) curve was created for the constructed predictive model. The Area Under the Curve was AUC = 0.806 with a 95 % confidence interval (0.747, 0.864). The predictive model constructed in this study has been validated using an independent data set, which indicates that the model is reliable and repeatable.
Time-lapse imaging presents a new diagnostic tool for parametric evaluation of embryo development, from the oocyte stage, through fertilization, up to the blastocyst stage. The assessment of morphokinetic parameters can help us to provide more accurate information about the reproductive potential of embryos. It allows for early selection of embryos with high reproductive potential and shortens embryo incubation.
本研究旨在基于延时胚胎监测仪监测的胚胎发育动力学参数建立囊胚发育预测模型。
本研究纳入了在胚胎监测仪中监测的432枚胚胎（来自77例患者）的延时记录。患者于2012年6月至2013年4月期间按照标准程序接受体外受精。对胚胎发育动力学特征进行回顾性分析，重点关注从卵胞浆内单精子注射（ICSI）操作到2、3、4和5个卵裂球连续分裂的时间，以及每次分裂之间的时间间隔。所有胚胎观察5天。
根据分析的胚胎发育动力学参数分布和发育至囊胚的胚胎数量，确定了表示胚胎达到囊胚阶段可能性的范围。根据所得结果，进行了单因素和多因素逻辑回归分析。基于2细胞和5细胞的分裂时间以及第二次和第三次分裂之间的间隔，建立了多因素预测模型。基于逻辑回归分析参数（比值比）构建了预测方程。在发育至囊胚的胚胎组（中位数：Me = 9.95，四分位数：Q1 = 7.59，Q3 = 12.30）和未发育至囊胚阶段的胚胎组（Me = 4.66，Q1 = 2.33，Q3 = 8.19）之间，预测参数大小存在统计学显著差异（p < 0.001）。为构建的预测模型创建了受试者工作特征（ROC）曲线。曲线下面积为AUC = 0.806，95%置信区间为（0.747，0.864）。本研究构建的预测模型已使用独立数据集进行验证，这表明该模型可靠且可重复。
延时成像为从卵母细胞阶段、受精直至囊胚阶段的胚胎发育参数评估提供了一种新的诊断工具。胚胎发育动力学参数评估有助于我们提供有关胚胎生殖潜能的更准确信息。它允许早期选择具有高生殖潜能的胚胎并缩短胚胎培养时间。
