Chongqing Key Laboratory of Human Embryo Engineering Chongqing, China; Center for Reproductive Medicine, Reproductive and Genetic Institute, Women and Children's Hospital of Chongqing Medical University Chongqing, China.
IVF Clinical Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou Henan, China.
Reprod Biomed Online. 2022 Nov;45(5):858-866. doi: 10.1016/j.rbmo.2022.06.017. Epub 2022 Jun 28.
What are the potential clinical benefits of embryo culture and assessment in a time-lapse incubator compared with a standard incubator using static assessment?
This large multicentre, single-blinded, randomized controlled study included 1224 participants randomly assigned (1:1) to the time-lapse or standard incubator group. In all patients one or two embryos were transferred on day 3. The primary outcome was the implantation rate in the first embryo transfer cycle. Secondary outcomes included the cumulative implantation rate, live birth rate in the first embryo transfer cycle and cumulative live birth rate.
Among 1224 participants recruited, 1182 underwent embryo transfer. The number of successfully implanted embryos in the first transfer cycle was significantly higher in the time-lapse incubator group (time-lapse group: 52.35%, standard incubator group: 47.11%, P = 0.014). The implantation rate in the first embryo transfer cycle was still significantly higher in the time-lapse group than the standard incubator group after adjusting for age, body mass index, medical centre and embryo status (relative risk 1.11, 95% confidence interval 1.02-1.20, P = 0.020). However, the cumulative implantation rate, live birth rate in the first embryo transfer cycle and cumulative live birth rate were not statistically different between the groups.
The implantation rate in the first embryo transfer cycle was significantly improved in the time-lapse group, but the effect of the time-lapse system on the cumulative implantation rate or cumulative live birth rate was not significant. The embryo assessment method offered by time-lapse systems rather than an undisturbed environment may play an important role in improving the implantation rate in the first embryo transfer cycle. These results are only applicable to young patients.
与使用静态评估的标准培养箱相比，延时培养箱培养和评估胚胎有哪些潜在的临床益处？
这项大型多中心、单盲、随机对照研究纳入了 1224 名参与者，随机（1:1）分配到延时培养箱组或标准培养箱组。所有患者均在第 3 天移植 1 或 2 个胚胎。主要结局是首次胚胎移植周期的种植率。次要结局包括累积种植率、首次胚胎移植周期的活产率和累积活产率。
在招募的 1224 名参与者中，有 1182 名进行了胚胎移植。首次移植周期中成功着床的胚胎数量在延时培养箱组显著更高（延时培养箱组：52.35%，标准培养箱组：47.11%，P=0.014）。在调整年龄、体重指数、医疗中心和胚胎状态后，首次胚胎移植周期的种植率在延时培养箱组仍显著高于标准培养箱组（相对风险 1.11，95%置信区间 1.02-1.20，P=0.020）。然而，两组间的累积种植率、首次胚胎移植周期的活产率和累积活产率无统计学差异。
首次胚胎移植周期的种植率在延时培养箱组显著提高，但延时系统对累积种植率或累积活产率的影响不显著。延时系统提供的胚胎评估方法而不是无干扰的环境可能在提高首次胚胎移植周期的种植率方面发挥重要作用。这些结果仅适用于年轻患者。
