Different effectiveness of closed embryo culture system with time-lapse imaging (EmbryoScopeTM) in comparison to standard manual embryology in good and poor prognosis patients: a prospectively randomized pilot study
Different effectiveness of closed embryo culture system with time-lapse imaging (EmbryoScopeTM) in comparison to standard manual embryology in good and poor prognosis patients: a prospectively randomized pilot study
复制标题
与标准手动胚胎学相比，延时成像封闭式胚胎培养系统 (EmbryoScopeTM) 对预后良好和不良患者的不同效果：一项前瞻性随机试点研究
DOI：
--
复制
发表时间：
2016
影响因子：
4.4
通讯作者：
N. Gleicher
中科院分区：
文献类型：
--
作者：
Yan;E. Lazzaroni;Qi Wang;Lin Zhang;D. Barad;V. Kushnir;S. Darmon;D. Albertini;N. Gleicher
背景在许多体外受精（IVF）中心，以前人工的人类胚胎学正在迅速被具有延时成像的封闭胚胎孵育系统所取代。然而，这种系统是否在不同的IVF患者人群中进行人工胚胎学研究，以前从未被调查过。因此，我们前瞻性地比较了封闭系统培养后的胚胎质量，延时摄影（EmbryoScope™）和标准胚胎学。我们在IVF中进行了两部分前瞻性随机研究（临床试验#NCT 92256309）。A部分涉及31名预后不良的不育患者，前瞻性随机分配至EmbryoScope™和标准胚胎学组。B部分涉及来自17个卵子供体-受体周期的胚胎，导致大量卵子/胚胎数量，从而允许前瞻性地将胚胎分配给EmbryoScope™和标准胚胎学。然后，我们比较了受精后第3天的妊娠率和胚胎质量以及胚胎学家处理每个胚胎所用的时间。结果A部分显示，预后不良患者在第3天胚胎评分方面没有差异，EmbryoScope™和标准胚胎学之间的着床率和临床妊娠率。然而，EmbryoScope™使胚胎学工作人员的时间增加了一倍以上（P < 0.0001）。在部分B中，在EmbyoScope™中生长的胚胎显示出显著较差的第3天质量（取决于P = 0.005和P = 0.01之间的胚胎参数）。怀疑EmbryoScope™（EmbryoSlide™）的锥形培养皿可能是原因被推翻时，标准培养皿证明没有结果差异，在标准incubation.ConclusionsThough由于小患者人数初步，这项研究引起了关注的大部分不受控制的引进封闭的孵育系统与时间推移成像到常规临床胚胎学。在这些工具的不受控制的使用进一步扩大之前，迫切需要在明确定义的患者人群中进行适当设计和把握度的前瞻性随机研究。
BackgroundPreviously manual human embryology in many in vitro fertilization (IVF) centers is rapidly being replaced by closed embryo incubation systems with time-lapse imaging. Whether such systems perform comparably to manual embryology in different IVF patient populations has, however, never before been investigated.We, therefore, prospectively compared embryo quality following closed system culture with time-lapse photography (EmbryoScope™) and standard embryology.We performed a two-part prospectively randomized study in IVF (clinical trial # NCT92256309). Part A involved 31 infertile poor prognosis patients prospectively randomized to EmbryoScope™ and standard embryology. Part B involved embryos from 17 egg donor-recipient cycles resulting in large egg/embryo numbers, thus permitting prospectively alternative embryo assignments to EmbryoScope™ and standard embryology.We then compared pregnancy rates and embryo quality on day-3 after fertilization and embryologist time utilized per processed embryo.ResultsPart A revealed in poor prognosis patients no differences in day-3 embryo scores, implantation and clinical pregnancy rates between EmbryoScope™ and standard embryology. The EmbryoScope™, however, more than doubled embryology staff time (P < 0.0001). In Part B, embryos grown in the EmbyoScope™ demonstrated significantly poorer day-3 quality (depending on embryo parameter between P = 0.005 and P = 0.01). Suspicion that conical culture dishes of the EmbryoScope™ (EmbryoSlide™) may be the cause was disproven when standard culture dishes demonstrated no outcome difference in standard incubation.ConclusionsThough due to small patient numbers preliminary, this study raises concerns about the mostly uncontrolled introduction of closed incubation systems with time lapse imaging into routine clinical embryology. Appropriately designed and powered prospectively randomized studies appear urgently needed in well-defined patient populations before the uncontrolled utilization of these instruments further expands.Trial registrationNCT02246309 Registered September 18, 2014.
影响因子：
4
作者：
Brison, Daniel R.;Roberts, Stephen A.;Kimber, Susan J.
通讯作者：
Kimber, Susan J.