Ebner Thomas, Höggerl Alexandra, Oppelt Peter, Radler Elisabeth, Enzelsberger Simon-Hermann, Mayer Richard B, Petek Erwin, Shebl Omar
Department of Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University Clinic, Campus IV, Krankenhausstr. 26-30, 4020, Linz, Upper Austria, Austria.
Institute of Human Genetics, Medical University of Graz, Graz, Styria, Austria.
Arch Gynecol Obstet. 2017 Dec;296(6):1199-1205. doi: 10.1007/s00404-017-4531-5. Epub 2017 Sep 20.
Recently, guidelines on the annotation of dynamic human embryo monitoring recommended screening for the presence of planar blastomere arrangement at the 4-cell stage. This observational study was set up in order to analyze whether developmental kinetics of planar human embryos are different from tetrahedral ones.
Therefore, embryos of 115 consecutive ICSI patients (showing 32 planar and 554 tetrahedral embryos) were cultured in a new time-lapse system (Miri TL) and their embryos were annotated for morphokinetic development and screened for irregular cleavages and morphological dysmorphisms.
Significantly less planar embryos reached blastocyst stage and showed worse quality as compared to regular tetrahedral embryos. The rate of bi- and/or multinucleation was also significantly higher in the affected group. Irregular cleavages, particularly embryo rolling, were more often seen in planar embryos. Morphokinetics between planar and tetrahedral were distinguishable up to 4-cell stage (t2-t4), thereafter the observed delay in planar embryos (t8) was more likely the result of a higher rate of arrested embryos in the planar group.
Planar embryos are associated with both a significant increase in irregular cleavage as well as a delay in preimplantation development. This indicates that planar embryos are rather abnormal and should only be considered for transfer if no other embryos are available.
最近，关于动态人类胚胎监测注释的指南建议在4细胞阶段筛查扁平卵裂球排列的存在情况。本观察性研究旨在分析扁平人类胚胎的发育动力学是否与四面体胚胎不同。
因此，对115例连续接受ICSI治疗患者的胚胎（其中有32个扁平胚胎和554个四面体胚胎）在新的延时系统（Miri TL）中进行培养，并对其胚胎的形态动力学发育进行注释，同时筛查不规则分裂和形态学异常。
与正常四面体胚胎相比，扁平胚胎发育至囊胚阶段的数量明显更少，且质量更差。受影响组的双核和/或多核发生率也明显更高。不规则分裂，尤其是胚胎旋转，在扁平胚胎中更常见。扁平胚胎和四面体胚胎在4细胞阶段（t2-t4）之前的形态动力学是可区分的，此后扁平胚胎中观察到的延迟（t8）更可能是由于扁平组中胚胎停滞率较高所致。
扁平胚胎与不规则分裂的显著增加以及植入前发育的延迟有关。这表明扁平胚胎相当异常，只有在没有其他胚胎可用时才应考虑移植。
