Basile Natalia, Caiazzo Mauro, Meseguer Marcos
aIVI Madrid, Madrid bIVI Valencia, Valencia, Spain.
Curr Opin Obstet Gynecol. 2015 Jun;27(3):193-200. doi: 10.1097/GCO.0000000000000166.
Time lapse technology represents a new tool in the in-vitro fertilization (IVF) laboratory. It can aid the embryologist in the detection of objective and quantifiable markers associated with embryo viability and implantation. The purpose of this review is to explain how embryo morphokinetics can be used as an adjunct to standard morphological assessment and to evaluate its potential value to improve IVF outcomes.
Several algorithms have been developed. Some utilize early kinetic markers, whereas others rely more on later stages of embryo development. Even though over a handful of randomized control trials are in progress, at this point, only one has been published demonstrating a significant increase in implantation rates and ongoing pregnancy rates when selecting embryos on the basis of a combination of morphological assessment and morphokinetics.
We believe that standard morphological assessment should remain the gold standard to initiate embryo evaluation; however, if possible, it can be complemented with the use of morphokinetics. This new approach will allow the embryologist to perform a more accurate and objective embryo selection and therefore reduce the number of embryos transferred while maintaining or even improving clinical results.
延时技术是体外受精(IVF)实验室中的一种新工具。它可以帮助胚胎学家检测与胚胎活力和着床相关的客观且可量化的指标。本综述的目的是解释胚胎形态动力学如何用作标准形态学评估的辅助手段,并评估其对改善IVF结局的潜在价值。
已开发出几种算法。一些算法利用早期动力学指标,而其他算法更多地依赖于胚胎发育的后期阶段。尽管有几项随机对照试验正在进行中,但目前仅发表了一项试验,该试验表明在结合形态学评估和形态动力学选择胚胎时,着床率和持续妊娠率有显著提高。
我们认为标准形态学评估应仍然是启动胚胎评估的金标准;然而,如果可能的话,可以用形态动力学进行补充。这种新方法将使胚胎学家能够进行更准确、客观的胚胎选择,从而在维持甚至改善临床结果的同时减少移植胚胎的数量。