Gabrielsen Anette, Iversen Lea Hedegaard, Fedder Jens, Eskildsen Tilde Veng, Englund Anne Lis, Hansen Stine Ravn, Pinton Philippe
Fertility Clinic, Horsens Regional Hospital, 8700 Horsens, Denmark.
Centre of Andrology & Fertility Clinic, Odense University Hospital, University of Southern Denmark, 5000 Odense, Denmark.
J Clin Med. 2023 Oct 6;12(19):6389. doi: 10.3390/jcm12196389.
Human IVF embryos that are not used for fresh transfer are cryopreserved by vitrification for later embryo transfers. This study evaluates pre-vitrification and post-warming embryo characteristics that are suitable to predict the chance of clinical pregnancy in single vitrified blastocyst transfer (SVBT) cycles. In a multicenter observational trial (IMBOS trial), embryos were cultured in a time-lapse system before and after vitrification. Associations between clinical pregnancy, morphokinetic parameters, blastocyst collapse, KIDScore D5, pre-vitrification and post-warming Gardner scores, post-warming blastocyst size and re-expansion rates before SVBT were analyzed in 182 SVBTs which resulted in 89 clinical pregnancies. No association was found between clinical pregnancy after SVBT and the number of collapses or the maximal collapse size before vitrification. The multifactorial analysis of pre-vitrification Gardner scores showed a significant association with clinical pregnancy for trophectoderm grading but not for expansion/hatching status and inner cell mass grading. A significant association with clinical pregnancy was found for the time to reach a blastocyst after pronuclear fading (tB-tPNf), KIDScore D5 and post-warming size but not the rate of expansion or maximal expansion size. The selection of blastocysts for SVBT could benefit from using pre-vitrification parameters like tB-tPNf, trophectoderm grading and post-warming blastocyst size.
未用于新鲜移植的人类体外受精胚胎通过玻璃化冷冻保存，以备后续胚胎移植。本研究评估了玻璃化前和复温后的胚胎特征，这些特征适用于预测单囊胚玻璃化移植（SVBT）周期临床妊娠的几率。在一项多中心观察性试验（IMBOS试验）中，胚胎在玻璃化前后在延时系统中培养。在182例导致89例临床妊娠的SVBT中，分析了临床妊娠、形态动力学参数、囊胚塌陷、KIDScore D5、玻璃化前和复温后的Gardner评分、复温后囊胚大小以及SVBT前的再扩张率之间的关联。未发现SVBT后的临床妊娠与玻璃化前的塌陷次数或最大塌陷大小之间存在关联。玻璃化前Gardner评分的多因素分析显示，滋养外胚层分级与临床妊娠有显著关联，但与扩张/孵化状态和内细胞团分级无关。发现原核消失后达到囊胚的时间（tB - tPNf）、KIDScore D5和复温后大小与临床妊娠有显著关联，但与扩张率或最大扩张大小无关。选择用于SVBT的囊胚可受益于使用玻璃化前参数，如tB - tPNf、滋养外胚层分级和复温后囊胚大小。
