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极体活检对胚胎形态动力学的影响——是否重回胚胎植入前遗传学检测的根源?

Impact of polar body biopsy on embryo morphokinetics-back to the roots in preimplantation genetic testing?

机构信息

Das Kinderwunsch Institut Schenk GmbH, Am Sendergrund 11, 8143, Dobl, Austria.

Institute of Human Genetics, Medical University of Graz, Neue Stiftingtalstrasse 2, 8010, Graz, Austria.

出版信息

J Assist Reprod Genet. 2018 Aug;35(8):1521-1528. doi: 10.1007/s10815-018-1207-4. Epub 2018 May 22.

Abstract

PURPOSE

Polar body biopsy (PBB) is a common technique in preimplantation genetic testing (PGT) to assess the chromosomal status of the oocyte. Numerous studies have been implemented to investigate the impact of biopsies on embryo development; however, information on embryo morphokinetics is still lacking. Hence, we investigated the impact of PBB on morphokinetic parameters in early embryo development.

METHODS

Four hundred four embryos (202 PBB, 202 control) were retrospectively analyzed. Patients were stimulated with a gonadotropin-releasing hormone antagonist ovarian hyperstimulation protocol. After fertilization check, embryos were incubated in a time-lapse incubator. The groups were matched for maternal age at time of oocyte retrieval.

RESULTS

Mean group times for reaching specific developmental time points showed no significant difference comparing embryos with PBB conducted and without. Likewise, further subdivision of the PBB group in euploid and aneuploid embryos revealed no differences in the early embryo morphokinetic development compared to the control group. Aneuploidy testing revealed a high prevalence of chromosomal aberrations for chromosomes 21, 4, 16, and 19.

CONCLUSIONS

In conclusion, PBB does not impact the morphokinetic parameters of the embryo development. PBB can be safely applied without the risk of impairing the reproductive potential of the embryo and can be highly recommended as safe and practicable PGT approach, especially in countries with prevailing restrictions regarding PGT analysis.

摘要

目的

极体活检(PBB)是一种常见的胚胎植入前遗传学检测(PGT)技术,用于评估卵母细胞的染色体状态。已经进行了许多研究来调查活检对胚胎发育的影响;然而,关于胚胎形态动力学的信息仍然缺乏。因此,我们研究了 PBB 对早期胚胎发育中形态动力学参数的影响。

方法

回顾性分析了 404 个胚胎(202 个 PBB,202 个对照)。患者接受促性腺激素释放激素拮抗剂卵巢超刺激方案刺激。受精检查后,胚胎在延时孵育器中孵育。两组在卵母细胞采集时的母亲年龄相匹配。

结果

与未进行 PBB 的胚胎相比,进行 PBB 的胚胎达到特定发育时间点的平均组时间没有显著差异。同样,将 PBB 组进一步细分为整倍体和非整倍体胚胎,与对照组相比,早期胚胎形态动力学发育没有差异。非整倍体检测显示染色体 21、4、16 和 19 存在高比例的染色体异常。

结论

总之,PBB 不会影响胚胎发育的形态动力学参数。PBB 可以安全应用,而不会损害胚胎的生殖潜能,可以作为安全可行的 PGT 方法强烈推荐,特别是在普遍存在 PGT 分析限制的国家。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ebd6/6086803/7782920ca88f/10815_2018_1207_Fig1_HTML.jpg

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