Department of Obstetrics, Gynecology, and Reproductive Biology, Division of Reproductive Endocrinology and Infertility, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, ASB I-3, Boston, MA, 02115, USA.
Department of Obstetrics and Gynecology, Women & Infants Hospital of Rhode Island, 101 Dudley Street, Providence, RI, 02905, USA.
J Assist Reprod Genet. 2017 Sep;34(9):1167-1172. doi: 10.1007/s10815-017-0964-9. Epub 2017 Jun 10.
Several time-lapse imaging (TLI) systems for non-invasive continuous monitoring of developing embryos are currently available. The present study explored the prevalence, means of acquisition, and clinical application of TLI systems in USA in vitro fertilization (IVF) laboratories.
An online cross-sectional survey of 294 USA IVF laboratory directors was conducted in February and March 2016. Those directing more than one laboratory were asked to complete the survey for their home program and for their smallest laboratory by number of IVF/intracytoplasmic sperm injection (ICSI) cycle starts. Use of TLI was analyzed using logistic regression to calculate odds ratios (OR).
Of 294 directors surveyed, 162 (55%) reported data on 204 laboratories. Thirty-five laboratories (17%) possessed at least one TLI system (median 2, interquartile range 1-4, total range 1-11). The more oocyte retrievals a laboratory performed annually, the more likely the laboratory was to possess a TLI system. Fifteen laboratories (43%) purchased their own systems, while others leased, loaned, or received donated systems. Twenty-five laboratories (71%) reported using TLI for embryo selection; all used TLI always, or usually, in combination with standard morphology evaluation. Twenty laboratories (80%) offered TLI to all patients. Some laboratories charged patients for TLI. Directors with TLI systems were more inclined to believe that TLI has value for embryo selection in clinical IVF.
TLI system possession in USA IVF laboratories is low, although positively associated with the number of retrievals performed and with directors' opinions on the technology's utility. Over 70% of laboratories with TLI systems use them clinically, and less than half purchased their systems.
目前已有多种用于非侵入性连续监测胚胎发育的延时成像（TLI）系统。本研究探讨了美国体外受精（IVF）实验室中 TLI 系统的流行情况、采集方式及临床应用。
2016 年 2 月至 3 月，对 294 名美国 IVF 实验室主任进行了在线横断面调查。对于管理多个实验室的主任，要求其为所在的主要实验室和实验室数量最少的实验室分别完成调查。使用逻辑回归分析 TLI 的使用情况，计算比值比（OR）。
在接受调查的 294 名主任中，有 162 名（55%）报告了 204 个实验室的数据。35 个实验室（17%）拥有至少一个 TLI 系统（中位数 2，四分位间距 1-4，总范围 1-11）。实验室每年进行的取卵次数越多，拥有 TLI 系统的可能性就越大。15 个实验室（43%）购买了自己的系统，而其他实验室则租用、贷款或接受捐赠的系统。25 个实验室（71%）报告使用 TLI 进行胚胎选择；所有实验室均始终或通常与标准形态评估相结合使用 TLI。20 个实验室（80%）向所有患者提供 TLI。一些实验室向患者收取 TLI 费用。拥有 TLI 系统的主任更倾向于认为 TLI 对临床 IVF 中的胚胎选择具有价值。
美国 IVF 实验室 TLI 系统的拥有率较低，但与取卵次数呈正相关，且与主任对该技术实用性的看法相关。超过 70%的拥有 TLI 系统的实验室在临床上使用该系统，不到一半的实验室购买了自己的系统。
