Time-Lapse Cleavage Rating Predicts Human Embryo Viability
Time-Lapse Cleavage Rating Predicts Human Embryo Viability
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DOI：
10.33549/physiolres.932287
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发表时间：
2012-01-01
影响因子：
2.1
通讯作者：
Dudas, M.
中科院分区：
文献类型：
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作者：
Hlinka, D.;Kal'atova, B.;Dudas, M.
通过延时成像研究了人类植入前胚胎中三个连续有丝分裂事件的时间顺序。在产生发育良好和妊娠产生的扩张囊胚的合子中，显示了卵裂簇（c）和间期（i）的均匀时间模式：i2=11+/-1，i3=15+/-1，i4=23+/-1 h / c2=15+/-5，c3=40+/-10，c4=55+/-15 min。一个或多个细胞周期持续时间的缩短或延长强烈预示着植入和发育不良。此外，在17%的病例中发现了减数分裂有丝分裂-受精卵分裂为3个卵裂球，2细胞胚胎分裂为5-6个细胞（而不是正常的2和4）。在常规的临床评估中，这些胚胎与正常胚胎无法区分，通常被认为是下一个细胞周期的过程中。只有每隔10分钟进行一次详细的延时监测，才能证明所有这些胚胎都是绝对不能存活的，即使在极少数情况下，当它们通过细胞-细胞融合将细胞过多减少到正常细胞计数时也是如此。总体而言，我们证明，延时胚胎卵裂评级（ECR）作为一种独立的诊断程序，可以以90%的特异性有效识别存活的早期胚胎，而排除好看但不存活的胚胎的特异性为100%。因此，这种非侵入性和非接触式的方法值得在临床IVF计划中进行常规胚胎筛查。
Chronology of three consecutive mitotic events in human preimplantation embryos was examined by time-lapse imaging. In zygotes producing well-formed and pregnancy-yielding expanded blastocysts, uniform time-patterning of cleavage clusters (c) and interphases (i) was revealed: i2=11+/-1, i3=15+/-1, i4=23+/-1 h / c2=15+/-5, c3=40+/-10, c4=55+/-15 min. Oppositely, shortened or prolonged durations of one or more cell cycles were strongly predictive of poor implantation and development. Furthermore, trichotomic mitosis was discovered in 17 % of cases - zygotes cleaved into 3 blastomeres and 2-cell embryos into 5-6 cells (instead of normal 2 and 4). During conventional clinical assessment, such embryos are indistinguishable from normal, often considered just-in-course of the next cell cycle. Only detailed time-lapse monitoring paced at 10-minute intervals had proven all these embryos to be absolutely unviable, even in rare cases when they reduced their hypercellularity to normal cell counts via cell-cell fusion. Overall, we demonstrate that time-lapse embryo cleavage rating (ECR) as a standalone diagnostic procedure allows for effective identification of viable early embryos with 90 % specificity, while elimination of good-looking but unviable embryos can be assumed with a specificity of 100 %. Thus, making this non-invasive and contactless approach worth of addition to routine embryo screening in clinical IVF programs.