Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California.
Department of Obstetrics and Gynecology, Kaiser Permanente, Los Angeles, California.
JBRA Assist Reprod. 2021 Jul 21;25(3):373-382. doi: 10.5935/1518-0557.20200101.
To determine the rate of live birth per blastocyst based on morphology and oocyte age using data from a single center.
This is a mathematical analysis and model building study of autologous blastocyst stage embryo transfers at a University-affiliated center. A total of 448 blastocyst stage embryos were transferred in 244 fresh and frozen embryo transfers from May 2015 through April 2018. Blastocyst morphology was divided into good, fair, and poor overall morphology grades. Each embryo transfer was modeled as an equation equating the sum of the unknown live birth rates of the transferred embryos to the number of live births that resulted. The least squares solution to the system of embryo transfer equations was determined using linear algebra.
Trophectoderm morphology was a better predictor of live birth rate than inner cell mass morphology. Embryos graded AA/AB/BA (good) had the highest live birth rates followed by BB/CB (fair), and BC/CC (poor). In our youngest age group (25-32 years) live birth rates per embryo were 51% for good, 39% for fair, and 25% for poor quality embryos. In our oldest age group (40-44 years) the live birth rates per embryo were 22% for good, 14% for fair, and 8% for poor quality embryos.
These techniques can help analyze small datasets such as those from individual clinics to aid in determining the ideal number of embryos to transfer to achieve live birth while limiting the risk of multiple gestations.
利用单中心数据，根据形态和卵母细胞年龄确定每个囊胚的活产率。
这是一项对大学附属中心的自体囊胚期胚胎移植的数学分析和模型构建研究。在 2015 年 5 月至 2018 年 4 月期间，共有 244 例新鲜胚胎和冷冻胚胎移植中，共移植了 448 个囊胚期胚胎。将囊胚形态分为整体形态良好、一般和较差三个等级。将每个胚胎转移建模为一个方程，将转移胚胎的未知活产率之和与导致的活产数相等。使用线性代数确定胚胎转移方程系统的最小二乘解。
滋养层形态比内细胞团形态更能预测活产率。AA/AB/BA 级（良好）的胚胎具有最高的活产率，其次是 BB/CB（一般）和 BC/CC（较差）。在我们最年轻的年龄组（25-32 岁）中，优质胚胎的活产率为 51%，一般胚胎为 39%，较差胚胎为 25%。在我们最年长的年龄组（40-44 岁）中，优质胚胎的活产率为 22%，一般胚胎为 14%，较差胚胎为 8%。
这些技术可以帮助分析单个诊所的小数据集，以确定理想的胚胎移植数量，从而在限制多胎妊娠风险的同时实现活产。
