卵裂期形态动力学和形态学动态对胚胎发育潜能的影响：一项延时研究。

Effect of morphokinetics and morphological dynamics of cleavage stage on embryo developmental potential: A time-lapse study.

作者信息

Yang Shiao-Hsuan, Wu Cheng-Hsuan, Chen Yu-Ching, Yang Chueh-Ko, Wu Tsui-Huang, Chen Pei-Chi, Tsai Horng-Der

机构信息

Reproductive Medicine Center, Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan, R.O.C.

Reproductive Medicine Laboratory, Department of Medical Research, Changhua Christian Hospital, Changhua, Taiwan, R.O.C.

出版信息

Taiwan J Obstet Gynecol. 2018 Feb;57(1):76-82. doi: 10.1016/j.tjog.2017.12.013.

DOI:10.1016/j.tjog.2017.12.013

PMID:29458909

Abstract

OBJECTIVE

Using a non-invasive method to select the most competent embryo is essential in in vitro fertilization (IVF). Since the beginning of clinical application of time-lapse technology, several studies have proposed models using the time-lapse imaging system for predicting the IVF outcome. This study used both morphokinetic and morphological dynamic parameters to select embryos with the highest developmental potential.

MATERIALS AND METHODS

A total of 23 intracytoplasmic sperm injection treatment cycles with 138 fertilized oocytes were included in this study. All embryos were cultured to the blastocyst stage, and embryo development was recorded every 10 min by using a time-lapse imaging system. Morphokinetic parameters and eight major abnormal division behaviors were studied to determine their effects on blastocyst formation. The most influential variables were used in hierarchical classification for blastocyst formation prediction.

RESULTS

Several parameters were significantly related to the developmental potential. Embryos with the timing of pronuclear fading (tPNF) of >26.4 h post insemination (hpi), the timing of division to two cells (t2) of >29.1 hpi, and the timing of division to four cells (t4) of >41.3 hpi showed the lowest blastocyst formation rate. The abnormal division behaviors of fragmentation >50%, direct cleavage, reverse cleavage, and delayed division or developmental arrest were found to be detrimental to blastocyst formation. On the basis of these results, we propose a hierarchical model classification, in which embryos are classified into groups A-D according to their developmental potential. The blastocyst formation rates of groups A, B, C, and D were 80.0%, 77.8%, 53.7%, and 22.2% (p < 0.001). The good blastocyst rates of groups A, B, C, and D were 60.0%, 44.4%, 14.6%, and 11.1% (p = 0.007).

CONCLUSION

We propose a hierarchical classification system for blastocyst formation prediction, which provides information for embryo selection by using a time-lapse imaging system.

摘要

目的

在体外受精（IVF）中，使用非侵入性方法选择最具发育潜能的胚胎至关重要。自延时技术开始临床应用以来，多项研究提出了使用延时成像系统预测IVF结局的模型。本研究采用形态动力学和形态学动态参数来选择具有最高发育潜能的胚胎。

材料与方法

本研究纳入了23个卵胞浆内单精子注射治疗周期，共138枚受精的卵母细胞。所有胚胎均培养至囊胚阶段，使用延时成像系统每10分钟记录一次胚胎发育情况。研究形态动力学参数和8种主要的异常分裂行为，以确定它们对囊胚形成的影响。将最具影响力的变量用于囊胚形成预测的分层分类。

结果

多个参数与发育潜能显著相关。授精后原核消失时间（tPNF）>26.4小时、分裂为2细胞时间（t2）>29.1小时、分裂为4细胞时间（t4）>41.3小时的胚胎，其囊胚形成率最低。发现碎片率>50%、直接分裂、反向分裂以及延迟分裂或发育停滞等异常分裂行为对囊胚形成不利。基于这些结果，我们提出了一种分层模型分类方法，根据胚胎的发育潜能将其分为A - D组。A、B、C、D组的囊胚形成率分别为80.0%、77.8%、53.7%和22.2%（p<0.001）。A、B、C、D组的优质囊胚率分别为60.0%、44.4%、14.6%和11.1%（p = 0.007）。