胚胎形态动力学参数在胚胎整倍体预测模型构建中的应用研究

doi:10.3969/j.issn.1006-6233.2024.09.016

Abstract
Figure/Table
References
Related Citation (7)

Download: PDF (1263 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To establish a prediction model for euploidy based on embryo morphokinetic parameters, so as to provide a reference for evaluating embryonic developmental potential in assisted reproductive technology.Methods: A retrospective analysis was performed on the clinical data of patients who underwent pre-implantation genetic testing between December 2020 and June 2023. A total of 1383 available blastocysts from 364 cycles were included. According to euploidy, the blastocysts were divided into the euploidy group (442 blastocysts) and the non-euploidy group (941 blastocysts). The morphokinetic parameters of the two groups were compared, and multivariate logistic regression analysis was performed. A prediction model for euploidy was constructed. The ROC curve was used to analyze the sensitivity and specificity of the prediction model. Meanwhile, morphokinetic parameters of 658 available blastocysts from 215 cycles included from July 2023 to April 2024 were used for clinical validation. The consistency between the prediction model and clinical practice was analyzed.Results: t4, t5, s2, time of starting blastulation (tSB), time of hatching blastocyst (tHB), and tHB-tSB in the euploidy group were shorter than those in the non-euploidy group (P<0.05). Logistic regression analysis found that t4, t5, s2, tSB, tHB, and tHB-tSB were influencing factors of blastocyst euploidy (P<0.05). A prediction model for euploidy was constructed as follows:P==e^x/(1+e^x), X=-3.299-0.026×t4-0.018×t5-0.264×s2-0.009×tSB-0.007×tHB-0.153×tHB-tSB. Hosmer-Lemeshow goodness of fit test showed that the prediction model had good goodness of fit (χ²=8.700, P=0.368). The area under the ROC curve of the prediction model was 0.871 (95%CI=0.852~0.889, P<0.001). Its sensitivity and specificity were 75.86% and 82.11%. Clinical validation indicated that the accuracy of the prediction model was 79.94%. The consistency between the prediction model and clinical practice was moderate (Kappa=0.561).Conclusion: Embryo morphokinetic parameters (t4, t5, s2, tSB, tHB and tHB-tSB) are related to the formation of euploidy. The prediction model constructed based on embryo morphokinetic parameters in this study is of high value in predicting embryo euploidy and can provide a reference for evaluating embryonic developmental potential.

Key words： Euploidy Pre-implantation genetic testing Morphokinetics Prediction model

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.09.016 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I9/1499

[1] 蔡溢,刘群,王姝,等.辅助生殖对妊娠早期自然流产胚胎染色体非整倍体的影响[J].中国优生与遗传杂志,2020,28(4):511-514.
[2] Leaver M,Wells D.Non-invasive preimplantation genetic testing (niPGT):the next revolution in reproductive genetics[J].Hum Reprod Update,2020,26(1):16-42.
[3] 蒲艳,郑爱燕,廖桂芝,等.高龄与非高龄复发性流产患者行胚胎植入前非整倍体检测的可行性分析[J].中国计划生育和妇产科,2023,15(1):82-87.
[4] Marquez S,Noriega L,Guzmán L.Time-Lapse Embryo culture:a better understanding of embryo development and clinical application[J].JBRA Assist Reprod,2022,26(3):432-443.
[5] Gimenez C,Conversa L,Murria L,et al.Time-lapse imaging:morphokinetic analysis of in vitro fertilization outcomes[J].Fertil Steril,2023,120(2):218-227.
[6] Huang B,Tan W,Li Z,et al.An artificial intelligence model (euploid prediction algorithm) can predict embryo ploidy status based on time-lapse data[J].Reprod Biol Endocrinol,2021,19(1):185-188.
[7] McNamee L,Clark S,Suskin B.Aneuploidy screening after preimplantation genetic testing:a national survey of physician knowledge and practice[J].Assist Reprod Genet,2023,40(3):665-669.
[8] 李红星,马晓玲,景原雪,等.非高龄患者囊胚整倍体率的形态学影响因素分析[J].中国计划生育学杂志,2020,28(11):1860-1863.
[9] Tvrdonova K,Belaskova S,Rumpikova T,et al.Differences in morphokinetic parameters and incidence of multinucleations in human embryos of genetically normal,abnormal and euploid embryos leading to clinical pregnancy[J].Clin Med,2021,10(21):5173-5176.
[10] Zou Y,Pan Y,Ge N,et al.Can the combination of time-lapse parameters and clinical features predict embryonic ploidy status or implantation[J].Reprod Biomed Online,2022,45(4):643-651.
[11] Nobrega NG,Abdala A,El-Damen A,et al.Sibling oocytes cultured in a time-lapse versus benchtop incubator:how time-lapse incubators improve blastocyst development and euploid rate[J].Zygote,2023,31(4):402-409.
[12] 朱家红,熊顺,武丽红,等.整倍体胚胎形态动力学参数对单囊胚移植妊娠结局的影响[J].中华生殖与避孕杂志,2023,43(9):898-903.
[13] Braga DPAF,Setti AS,Guilherme P,et al.Time-lapse monitoring:an adjunct tool to select embryos for preimplantation genetic testing[J].Mol Reprod Dev,2023,90(6):389-396.
[14] 郑爱燕,蒲艳,孟庆霞,等.形态动力学联合减数分裂纺锤体观测在卵裂期胚胎筛选中的应用[J].生殖医学杂志,2024,33(2):208-215.