Department of Physiology and Pharmacology; Department of Obstetrics and Gynaecology, Schulich School of Medicine and Dentistry, Western University, London Ontario N6A 5C1, Canada; Children's Health Research Institute; Lawson Health Research Institute, London Ontario, Canada.
Department of Physiology and Pharmacology; Department of Obstetrics and Gynaecology, Schulich School of Medicine and Dentistry, Western University, London Ontario N6A 5C1, Canada; Children's Health Research Institute; Lawson Health Research Institute, London Ontario, Canada.
Reprod Biomed Online. 2021 Jan;42(1):39-54. doi: 10.1016/j.rbmo.2020.11.011. Epub 2020 Nov 26.
Elective single embryo transfer is rapidly becoming the standard of care in assisted reproductive technology for patients under the age of 35 years with a good prognosis. Clinical pregnancy rates have become increasingly dependent on the selection of a single viable embryo for transfer, and diagnostic techniques facilitating this selection continue to develop. Current progress in elucidating the extracellular vesicle and microRNA components of the embryonic secretome is reviewed, and the potential for these findings to improve clinical embryo selection discussed. Key results have shown that extracellular vesicles and microRNAs are rapidly detectable constituents of the embryonic secretome. Evidence suggests that the vesicular population is largely exosomal in nature, secreted at all stages of preimplantation development and capable of traversing the zona pellucida. Both extracellular vesicle and microRNA concentrations within the secretome are elevated for blastocysts with diminished developmental competence, as indicated either by degeneracy or implantation failure, whereas studies have yet to firmly correlate individual microRNA sequences with pregnancy outcome. These emerging correlations support the viability of extracellular vesicles and microRNAs as the basis for a new diagnostic test to supplement or replace morphokinetic assessment.
选择性单胚胎移植在年龄在 35 岁以下、预后良好的患者的辅助生殖技术中迅速成为标准治疗方法。临床妊娠率越来越依赖于选择单个有活力的胚胎进行移植，而有助于这种选择的诊断技术也在不断发展。本文综述了胚胎外泌体和 microRNA 成分的最新研究进展，并讨论了这些发现提高临床胚胎选择的潜力。主要结果表明，外泌体和 microRNA 是胚胎分泌组中快速可检测的成分。有证据表明，囊泡群体主要是外泌体，在着床前发育的所有阶段分泌，并且能够穿透透明带。囊泡和 microRNA 的浓度在胚胎分泌组中都升高，对于发育能力下降的囊胚，退化或着床失败，而研究尚未将个别 microRNA 序列与妊娠结果进行确切关联。这些新兴的相关性支持了外泌体和 microRNAs 作为新的诊断测试的基础，以补充或取代形态动力学评估。
