Ten Jorge, Tio M Carmen, Pini Pedro, Kelley Korey, Guerrrero Jaime, Rodríguez-Arnedo Adoración, Zepeda Alexa, Mutter Alex, Diaz Nerea, Herreros Miguel, Latin Tom, Brualla Adriana, Hickman Cristina, Bernabeu Andrea, Bernabeu Rafael, Wiemer Klaus
Instituto Bernabeu, Alicante, Spain.
Fairtility, Buenos Aires, Argentina.
Reprod Biomed Online. 2025 Jul;51(1):104866. doi: 10.1016/j.rbmo.2025.104866. Epub 2025 Feb 15.
Do morphokinetic events (MKS) and patient parameters affect resulting embryo quality scores, and how does this relate to pregnancy outcomes as assessed by a time-lapse incubator using an artificial intelligence (AI) embryologist support tool?
Retrospective study analysing data from 6024 embryos retrieved over 1636 cycles. The dataset comprised 3778 donor oocytes and 2246 autologous oocytes. Additionally, 3309 biopsied embryos were included in the PGT-A analysis. Outcome data were derived from 1355 transferred embryos. All embryos were assessed using a time lapse-based AI system (CHLOE EQ™), which assigns an embryo quality score from 0 to 1 based upon established morphokinetic benchmarks. The AI embryo quality score was assigned on day 5 of embryo development. Analysed patient parameters were patient age, fresh or frozen oocyte status and use of own or donor oocytes. Twenty-three MKS were analysed. The effect of morphokinetics on the incidence of ploidy was also assessed.
Clinical outcomes are affected by embryo quality and MKS as detected by an AI software. Time to expanded blastocyst (tEB) was the morphokinetic parameter with the strongest correlation coefficient with embryo quality score (-0.816). As the patient's age increases by 1 unit, embryo quality score decreases significantly and time to achieve expanded blastocyst increases by 0.47 h. Similar trends were observed with frozen oocytes, which showed a 2.1 h increase in tEB compared with fresh oocytes. Autologous oocytes were associated with a 6.08 h longer tEB compared with donor oocytes. Additionally, euploid embryos reached tEB 4.72 h earlier than aneuploid embryos. For a one unit increase in embryo quality score, the odds of achieving clinical pregnancy increased by 21.7% and the odds of achieving ongoing pregnancy or live birth increased by 18.5%. Oocyte sources had an effect on miscarriage rates; the use of frozen oocytes resulted in higher miscarriage rates than observed when fresh oocytes were used.
AI can successfully evaluate embryo quality and can assist embryologists in decision making. Furthermore, this AI model can delineate the effect of various clinical factors on resulting outcomes.
形态动力学事件（MKS）和患者参数是否会影响最终的胚胎质量评分，以及这与使用人工智能（AI）胚胎学家支持工具的延时培养箱评估的妊娠结局有何关系？
回顾性研究，分析了1636个周期中回收的6024个胚胎的数据。数据集包括3778个供体卵母细胞和2246个自体卵母细胞。此外，PGT-A分析中纳入了3309个活检胚胎。结局数据来自1355个移植胚胎。所有胚胎均使用基于延时成像的AI系统（CHLOE EQ™）进行评估，该系统根据既定的形态动力学基准为胚胎质量打分，范围为0至1。AI胚胎质量评分在胚胎发育第5天给出。分析的患者参数包括患者年龄、新鲜或冷冻卵母细胞状态以及使用自身或供体卵母细胞情况。分析了23个MKS。还评估了形态动力学对倍性发生率的影响。
AI软件检测到，临床结局受胚胎质量和MKS影响。囊胚扩张时间（tEB）是与胚胎质量评分相关系数最强的形态动力学参数（-0.816）。患者年龄每增加1岁，胚胎质量评分显著降低，囊胚扩张时间增加0.47小时。冷冻卵母细胞也观察到类似趋势，与新鲜卵母细胞相比，tEB增加2.1小时。与供体卵母细胞相比，自体卵母细胞的tEB长6.08小时。此外，整倍体胚胎比非整倍体胚胎提前4.72小时达到tEB。胚胎质量评分每增加一个单位，临床妊娠几率增加21.7%，持续妊娠或活产几率增加18.5%。卵母细胞来源对流产率有影响；使用冷冻卵母细胞导致的流产率高于使用新鲜卵母细胞时。
AI能够成功评估胚胎质量，并可协助胚胎学家进行决策。此外，该AI模型可以描绘各种临床因素对最终结局的影响。
