Royère D, Hamamah S, Couet M L, Gervereau O, Ract V, Lanoue M, Lecomte C, Lansac J
Biologie de la reproduction, Dépt de Gyn-Obs et Reprod. Humaine, CHU Bretonneau, Tours.
Contracept Fertil Sex. 1996 Sep;24(9):653-6.
Assessing and/or improving the implantation prognostic remain a major goal for research studies as well as for teams doing embryo transfer in many species. Criteria for such a goal were focussed ten years ago and combined theoretically: -sensitivity for applying to one embryo; -clear cut-off for individual decision; -fastness to be suitable for embryo transfer in due time; -no toxicity or invasiveness for embryo; -finally some simple technical approach in order to be applies by a large number of teams. Moreover whatever may be qualitative or quantitative criteria, they should be relied to the final result as alive newborn. The more ancient way to appreciate embryo quality deal with the simple observation of morphological and kinetic criteria about embryo, but such non invasive approach was obviously limited, in spite of the positive influence of regular blastomers, absence of fragmentation and synchronization with time of transfer on implantation rate. The major transcriptional activity of human embryo developing between 6 and 8 cells stage, of course, were unassessed by transfer to day 2. Moreover the apparent quality of the embryo better reflected oocyte quality than embryo quality. Coculture development encompassed only partially such limitation. Using fluorescent probes, it was possible to evaluate some metabolic activity as well as membrane integrity, but such criteria revealed to be both invasive and uneasily reliable with developmental ability of the embryo. Methods dealing with glucidic, protidic or lipidic metabolisms are developed elsewhere, but revealed uneasy to apply, due both to their invasiveness or technical difficulties and their large inter-individual variability. Some hope has raised by the finding of growth factors or cytokines which are expressed by the embryo and/or embryotrophic but a lot of works remain to be down before an easy practical application.
评估和/或改善着床预后仍然是许多物种研究以及进行胚胎移植的团队的主要目标。十年前就确定了实现这一目标的标准，并在理论上进行了综合：对单个胚胎适用的敏感性；用于个体决策的明确临界值；适用于及时进行胚胎移植的快速性；对胚胎无毒性或侵袭性；最后是一种简单的技术方法以便大量团队能够应用。此外，无论质量标准还是数量标准，都应与存活新生儿这一最终结果相关联。评估胚胎质量的最古老方法是简单观察胚胎的形态和动力学标准，但这种非侵入性方法显然存在局限性，尽管规则的卵裂球、无碎片以及与移植时间同步对着床率有积极影响。当然，在第2天进行移植时，无法评估处于6至8细胞阶段的人类胚胎的主要转录活性。此外，胚胎的表观质量更好地反映了卵母细胞质量而非胚胎质量。共培养发育仅部分克服了这种局限性。使用荧光探针可以评估一些代谢活性以及膜完整性，但这些标准被证明既具有侵入性，又难以与胚胎的发育能力可靠关联。处理碳水化合物、蛋白质或脂质代谢的方法在其他地方也有发展，但由于其侵入性或技术困难以及个体间的巨大差异，应用起来并不容易。胚胎表达的生长因子或细胞因子的发现带来了一些希望，这些因子具有胚胎营养作用，但在能够轻松实际应用之前，仍有大量工作要做。
