The Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA.
IVIRMA Valencia, IVF, Valencia, Spain.
J Assist Reprod Genet. 2019 Apr;36(4):637-646. doi: 10.1007/s10815-018-1396-x. Epub 2019 Jan 22.
To demonstrate whether the standard morphokinetic markers used for embryo selection have a similar relationship to blastocyst formation and implantation in two large clinical data sets.
This is a retrospective cohort analysis striving to answer two distinct questions utilizing data sets from two large IVF clinics. Blastocysts (BL) and implanted blastocysts (I) in both clinics, IVI-Valencia (BL = 11,414, I = 479) and WMC (BL = 15,902; I = 337), were cultured in a time-lapse system (EmbryoScope, Vitrolife, Sweden). The study was designed to assess the relationship between early morphokinetic hallmarks and BL development, with a secondary analysis of implantation rates following single-embryo day 3 and day 5 transfers.
We performed a detailed graphical analysis for t3, t5, duration of the second cell cycle (cc2) (t3-t2), and the ratio (t5-t3)/(t5-t2). The t5 timing was not affected between the clinics. However, Weill Cornell Medicine's (WCM) proportions were significantly affected by having BL vs. not. A significant decrease of blastocysts with longer t5 in WCM data, while t5 was more informative in the IVI data set for the implantation rate.
Morphokinetic intervals for early cleavages were distributed differently between the clinics. Incorporation of embryo-selection algorithms depends on the individual clinic's selected developmental hallmarks, all of which must be validated before incorporation into clinical practice.
展示在两个大型临床数据集，胚胎选择的标准形态动力学标记物是否与囊胚形成和着床具有相似的关系。
这是一项回顾性队列分析，利用两个大型体外受精（IVF）诊所的数据来回答两个截然不同的问题。两个诊所（IVI-Valencia 和 WMC）的囊胚（BL）和着床囊胚（I）都在时间推移系统（EmbryoScope，Vitrolife，瑞典）中进行培养。该研究旨在评估早期形态动力学特征与 BL 发育之间的关系，并对单胚胎第 3 天和第 5 天转移后的着床率进行二次分析。
我们对 t3、t5、第二次细胞周期（cc2）的持续时间（t3-t2）和比率（t5-t3）/（t5-t2）进行了详细的图形分析。两个诊所之间的 t5 时间没有受到影响。然而，Weill Cornell Medicine（WCM）的比例受到有 BL 和无 BL 的显著影响。WCM 数据中 t5 较长的囊胚比例显著下降，而 IVI 数据集的 t5 对着床率更具信息性。
早期分裂的形态动力学间隔在诊所之间分布不同。胚胎选择算法的纳入取决于个别诊所选择的发育特征，所有这些特征都必须在纳入临床实践之前进行验证。
