Retrospective analysis of outcomes after IVF using an aneuploidy risk model derived from time-lapse imaging without PGS
Retrospective analysis of outcomes after IVF using an aneuploidy risk model derived from time-lapse imaging without PGS
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DOI：
10.1016/j.rbmo.2013.04.013
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发表时间：
2013-08-01
影响因子：
4
通讯作者：
Thornton, Simon
中科院分区：
文献类型：
--
作者：
Campbell, Alison;Fishel, Simon;Thornton, Simon
人类植入前体外受精胚胎的时间推移成像使基于新的发育观察(形态动力学)的客观算法能够用于临床胚胎选择。胚胎非整倍体是体外受精失败的一个主要原因，它已经与以前用于建立非整倍体风险分类模型的特定形态动力学变量相关联。本研究的目的是评估该模型对未经活检和植入前基因筛查(PGS)的未经选择的体外受精患者的有效性和潜在影响。根据计算的非整倍体风险等级(低、中、高)，比较了88个移植胚泡的胚胎结局-未植入、胎儿心跳(FHB)和活产(LB)。在被归类为低风险和中等风险的胚胎之间，FHB(P<；0.0001)和Lb(P<；0.01)的发生率有显著差异。在低风险类别中，FHB和LB的囊胚率分别比所有囊胚率高出74%和56%。受试者工作特性曲线下面积FHB为0.75，LB为0.74。这项研究证明了非整倍体风险分类模型的临床相关性，并介绍了一种新的、非侵入性的胚胎选择方法，以获得更高的着床率和活产率，而不需要PGS。RBMOnline(C)2013，Reductive Healthcare Ltd。爱思唯尔有限公司出版。版权所有。
Time-lapse imaging of human preimplantation IVF embryos has enabled objective algorithms based on novel observations of development (morphokinetics) to be used for clinical selection of embryos. Embryo aneuploidy, a major cause of IVF failure, has been correlated with specific morphokinetic variables used previously to develop an aneuploidy risk classification model. The purpose of this study was to evaluate the effectiveness and potential impact of this model for unselected IVF patients without biopsy and preimplantation genetic screening (PGS). Embryo outcomes - no implantation, fetal heart beat (FHB) and live birth (LB) - of 88 transferred blastocysts were compared according to calculated aneuploidy risk classes (low, medium, high). A significant difference was seen for FHB (P < 0.0001) and LB (P < 0.01) rates between embryos classified as low and medium risk. Within the low-risk class, relative increases of 74% and 56%, compared with rates for all blastocysts, were observed for FHB and LB respectively. The area under the receiver operating characteristic curve was 0.75 for FHB and 0.74 for LB. This study demonstrates the clinical relevance of the aneuploidy risk classification model and introduces a novel, non-invasive method of embryo selection to yield higher implantation and live birth rates without PGS. RBMOnline (C) 2013, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.