Hacettepe University School of Medicine, Department of Obstetric and Gynecology, 06100 Sihhiye, Ankara, Turkey.
Anatolia IVF and Women Health Centre, Cinnah Street 54 Cankaya, Ankara, Turkey.
Reprod Biomed Online. 2017 Dec;35(6):633-639. doi: 10.1016/j.rbmo.2017.08.025. Epub 2017 Sep 14.
Not all euploid embryos implant, necessitating additional tools to select viable blastocysts in preimplantation genetic screening cycles. In this retrospective cohort study, 129 consecutive patients who underwent 129 single euploid blastocyst transfers in cryopreserved embryo transfer cycles were included. All embryos were individually cultured in a time-lapse incubator from intracytoplasmic sperm injection up to trophoectoderm biopsy. Twenty-three time-lapse morphokinetic variables were tested among patients with (n = 68) or without (n = 61) ongoing pregnancy. All 23 time-lapse morphokinetic variables, apart from duration of blastulation (tB-tSB), were comparable between patients with or without ongoing pregnancy. Duration of blastulation was significantly shorter in patients with ongoing pregnancy (8.1 ± 3.2 versus 9.5 ± 3.4 h; P = 0.014); shorter duration of blastulation remained an independent predictor for ongoing pregnancy, when tested by logistic regression analysis (OR 0.81; 95% CI 0.70 to 0.93). One important limitation of this study, and a reason for caution, is the use of multiple comparisons, which can lead to differences at the 0.05 level simply by chance or random variation. Nonetheless, the study suggests that when more than one euploid blastocyst is available, priority might be given to those with a shorter duration of blastulation.
并非所有整倍体胚胎都能着床,因此在胚胎植入前遗传学筛查周期中需要额外的工具来选择有活力的囊胚。在这项回顾性队列研究中,纳入了 129 名连续患者,这些患者在冷冻胚胎移植周期中进行了 129 次单整倍体囊胚移植。所有胚胎均从胞浆内单精子注射开始,在延时培养箱中单独培养,直至滋养外胚层活检。在有(n=68)或无(n=61)持续妊娠的患者中测试了 23 个延时形态动力学变量。除了囊胚孵化时间(tB-tSB)外,所有 23 个延时形态动力学变量在有或无持续妊娠的患者之间均无差异。有持续妊娠的患者的囊胚孵化时间明显更短(8.1±3.2 小时 vs. 9.5±3.4 小时;P=0.014);在逻辑回归分析中,囊胚孵化时间较短仍然是持续妊娠的独立预测因素(OR 0.81;95%CI 0.70 至 0.93)。本研究的一个重要局限性,也是需要谨慎的原因,是使用了多次比较,这可能仅仅因为机会或随机变异而在 0.05 水平上产生差异。尽管如此,该研究表明,当有多个整倍体囊胚可供选择时,优先考虑那些囊胚孵化时间较短的囊胚。