Sigalos George Α, Triantafyllidou Olga, Vlahos Nikos F
2nd Department of Obstetrics and Gynecology, Aretaieion Hospital, University of Athens, Vas. Sofias Str. 76, 11528, Athens, Greece.
Reproductive Medicine Unit, "Lito" Maternity Hospital, Mouson Str. 7-13, 11524, Athens, Greece.
Arch Gynecol Obstet. 2016 Nov;294(6):1117-1124. doi: 10.1007/s00404-016-4196-5. Epub 2016 Sep 15.
The final success of an IVF attempt depends on several steps and decisions taken during the ovarian stimulation, the oocyte retrieval, the embryo culture and the embryo transfer. The final selection of the embryos most likely to implant is the final step in this process and the responsibility of the lab. Apart from strict morphologic criteria that historically have been used in embryo selection, additional information on genetic, metabolomic and morphokinetic characteristics of the embryo is recently combined to morphology to select the embryo most likely to produce a pregnancy. In this manuscript, we review the most recent information on the current methods used for embryo selection presenting the predictive capability of each one.
A literature search was performed on Pubmed, Medline and Cochrane Database of Systematic Reviews for published studies using appropriate key words and phrases with no limits placed on time.
It seems that the combination of morphologic criteria in conjunction to embryo kinetics as documented by time-lapse technology provides the most reliable information on embryo quality. Blastocyst biopsy with subsequent comprehensive chromosome analysis allows the selection of the euploid embryos with the higher implantation potential.
Embryo time-lapse imaging and blastocyst biopsy combined to comprehensive chromosome analysis are the most promising technologies to increase pregnancy rates and reduce the possibility of multiple pregnancies. However, further studies will demonstrate the capability of routinely using these technologies to significantly improve IVF outcomes.
体外受精（IVF）尝试的最终成功取决于卵巢刺激、卵母细胞采集、胚胎培养和胚胎移植过程中采取的几个步骤和做出的决策。最终选择最有可能着床的胚胎是这一过程的最后一步，也是实验室的职责。除了历史上用于胚胎选择的严格形态学标准外，最近还将有关胚胎的遗传、代谢组学和形态动力学特征的额外信息与形态学相结合，以选择最有可能实现妊娠的胚胎。在本手稿中，我们回顾了用于胚胎选择的当前方法的最新信息，并介绍了每种方法的预测能力。
在PubMed、Medline和Cochrane系统评价数据库上进行文献检索，以查找使用适当关键词和短语发表的研究，检索时间无限制。
延时技术记录的形态学标准与胚胎动力学相结合，似乎能提供关于胚胎质量最可靠的信息。囊胚活检及随后的全面染色体分析有助于选择具有更高着床潜力的整倍体胚胎。
胚胎延时成像和囊胚活检与全面染色体分析相结合，是提高妊娠率和降低多胎妊娠可能性最有前景的技术。然而，进一步的研究将证明常规使用这些技术显著改善IVF结局的能力。
