Nuñez-Calonge Rocío, Santamaria Nuria, Rubio Teresa, Manuel Moreno Juan
Unidad de Reproducción, International Group, Alicante, Spain.
Unidad de Reproducción Mediterráneo, Alicante, Spain.
Arch Med Res. 2024 Dec;55(8):103068. doi: 10.1016/j.arcmed.2024.103068. Epub 2024 Aug 26.
Currently, most assisted reproduction units transfer a single embryo to avoid multiple pregnancies. Embryologists must select the embryo to be transferred from a cohort produced by a couple during a cycle. This selection process should be accurate, non-invasive, inexpensive, reproducible, and available to in vitro fertilization (IVF) laboratories worldwide. Embryo selection has evolved from static and morphological criteria to the use of morphokinetic embryonic characteristics using time-lapse systems and artificial intelligence, as well as the genetic study of embryos, both invasive with preimplantation genetic testing for aneuploidies (PGT-A) and non-invasive (niPGT-A). However, despite these advances in embryo selection methods, the overall success rate of IVF techniques remains between 25 and 30%. This review summarizes the different methods and evolution of embryo selection, their strengths and limitations, as well as future technologies that can improve patient outcomes in the shortest possible time. These methodologies are based on procedures that are applied at different stages of embryo development, from the oocyte to the cleavage and blastocyst stages, and can be used in laboratory routine.
目前，大多数辅助生殖单位会移植单个胚胎以避免多胎妊娠。胚胎学家必须从一对夫妇在一个周期内产生的一批胚胎中选择要移植的胚胎。这种选择过程应该准确、无创、廉价、可重复，并且全球的体外受精（IVF）实验室都可以使用。胚胎选择已从静态和形态学标准发展到使用延时系统和人工智能的胚胎形态动力学特征，以及胚胎的遗传学研究，包括侵入性的植入前非整倍体基因检测（PGT-A）和非侵入性的（niPGT-A）。然而，尽管胚胎选择方法有这些进展，IVF技术的总体成功率仍在25%至30%之间。这篇综述总结了胚胎选择的不同方法及其演变、它们的优点和局限性，以及能够在尽可能短的时间内改善患者治疗结果的未来技术。这些方法基于在胚胎发育的不同阶段（从卵母细胞到分裂期和囊胚期）应用的程序，并且可用于实验室常规操作。
