时差成像技术用于胚胎选择的研究进展

doi:10.12280/gjszjk.20210592

摘要/Abstract

摘要：

时差成像（time-lapse imaging,TLI）技术是近年来出现的可以实时监控记录胚胎发育过程的新型无创胚胎培养及观察技术。分析TLI记录的形态动力学参数将有助于更全面地评估胚胎质量,以筛选出最优质的胚胎。通过综述性分析国内外已发表的文献,阐述了目前常用的与胚胎发育息息相关的形态动力学参数,并探讨其与胚胎发育潜能和染色体整倍性的相关性,及其在国内外应用于优选胚胎的现状,并客观评价了TLI技术目前在临床应用中的利弊。TLI可以弥补传统胚胎培养系统和形态学评分的不足,能够帮助胚胎学家更加精确地选择具有发育潜能的胚胎,是今后胚胎培养的趋势。但是作为一项新技术,TLI在应用中仍需要不断地改进和完善,尚需要更多研究来优化胚胎选择参数和建立胚胎选择模型。

关键词: 胚胎发育, 动力学, 时差成像技术, 胚胎评估, 形态学

Abstract:

Time-lapse imaging (TLI) is a novel and noninvasive embryo culture and observation technology that can monitor and record the embryonic development in real-time. The analysis of morphokinetic parameters recorded by TLI will help to evaluate the quality of embryos more comprehensively, so as to select the best embryo(s) for embryonic transfer (ET). This review expounds those commonly-used morphokinetic parameters that are closely linked with embryonic development, and discusses the association between these parameters and embryonic development potential and chromosome euploidy. The application status of TLI in embryo selection at present was evaluated, including its advantages and disadvantages. As described in the literature, TLI makes up the flaw of the traditional embryo culture system and morphologic evaluation for embryos, which is helpful for embryologists to select the embryos with developmental potential more accurately. TLI may be the trend of human embryo culture in the future. However, as a new technology, TLI still needs further improvement and perfection, and more research in the embryo selection parameters and embryonic selection models.

Key words: Embryonic development, Kinetics, Time-lapse imaging technology, Embryo evaluation, Morphology

陈志坚, 汪彩珠. 时差成像技术用于胚胎选择的研究进展[J]. 国际生殖健康/计划生育, 2022, 41(2): 139-142.

CHEN Zhi-jian, WANG Cai-zhu. Application of Time-Lapse Imaging Technology for Embryo Selection: A Review[J]. Journal of International Reproductive Health/Family Planning, 2022, 41(2): 139-142.

参考文献 29

[1]	Yang ST, Shi JX, Gong F, et al. Cleavage pattern predicts developmental potential of day 3 human embryos produced by IVF[J]. Reprod Biomed Online, 2015, 30(6):625-634. doi: 10.1016/j.rbmo.2015.02.008. doi: 10.1016/j.rbmo.2015.02.008 pmid: 25892500
[2]	Liu Y, Chapple V, Roberts P, et al. Prevalence, consequence, significance of reverse cleavage by human embryos viewed with the use of the Embryoscope time-lapse video system[J]. Fertil Steril, 2014, 102(5):1295-1300.e2. doi: 10.1016/j.fertnstert.2014.07.1235. doi: 10.1016/j.fertnstert.2014.07.1235
[3]	Ergin EG, Calişkan E, Yalçinkaya E, et al. Frequency of embryo multinucleation detected by time-lapse system and its impact on pregnancy outcome[J]. Fertil Steril, 2014, 102(4):1029-1033.e1. doi: 10.1016/j.fertnstert.2014.06.030. doi: 10.1016/j.fertnstert.2014.06.030
[4]	刘丽, 徐凤琴, 王媛媛, 等. 应用时差成像技术选择优质胚胎移植[J]. 中国妇幼保健, 2016, 31(20):4227-4229. doi: 10.7620/zgfybj.j.issn.1001-4411.2016.20.47. doi: 10.7620/zgfybj.j.issn.1001-4411.2016.20.47
[5]	Wong CC, Loewke KE, Bossert NL, et al. Non-invasive imaging of human embryos before embryonic genome activation predicts development to the blastocyst stage[J]. Nat Biotechnol, 2010, 28(10):1115-1121. doi: 10.1038/nbt.1686. doi: 10.1038/nbt.1686 URL
[6]	Herrero J, Tejera A, Albert C, et al. A time to look back: analysis of morphokinetic characteristics of human embryo development[J]. Fertil Steril, 2013, 100(6):1602-1609.e1-e4. doi: 10.1016/j.fertnstert. 2013.08.033. doi: 10.1016/j.fertnstert. 2013.08.033
[7]	王世凯, 薛林涛, 何冰, 等. 胚胎动力学参数与胚胎发育潜能关系的初步研究[J]. 中国临床新医学, 2016, 9(9):763-766. doi: 10.3969/j.issn.1674-3806.2016.09.01. doi: 10.3969/j.issn.1674-3806.2016.09.01
[8]	郑爱燕, 孟庆霞, 丁洁, 等. 利用胚胎实时观测技术预测早期胚胎的发育潜能[J]. 生殖医学杂志, 2018, 27(10):957-961. doi: 10.3969/j.issn.1004-3845.2018.10.006. doi: 10.3969/j.issn.1004-3845.2018.10.006
[9]	Chen M, Wei S, Hu J, et al. Can Comprehensive Chromosome Screening Technology Improve IVF/ICSI Outcomes? A Meta-Analysis[J]. PLoS One, 2015, 10(10):e0140779. doi: 10.1371/journal.pone.0140779. doi: 10.1371/journal.pone.0140779 URL
[10]	Zaninovic N, Irani M, Meseguer M. Assessment of embryo morphology and developmental dynamics by time-lapse microscopy: is there a relation to implantation and ploidy?[J]. Fertil Steril, 2017, 108(5):722-729. doi: 10.1016/j.fertnstert.2017.10.002. doi: S0015-0282(17)31970-2 pmid: 29101997
[11]	Basile N, Nogales MDC, Bronet F, et al. Increasing the probability of selecting chromosomally normal embryos by time-lapse morphokinetics analysis[J]. Fertil Steril, 2014, 101(3):699-704. doi: 10.1016/j.fertnstert.2013.12.005. doi: 10.1016/j.fertnstert.2013.12.005 URL
[12]	Nogales MDC, Bronet F, Basile N, et al. Type of chromosome abnormality affects embryo morphology dynamics[J]. Fertil Steril, 2017, 107(1):229-235.e2. doi: 10.1016/j.fertnstert.2016.09.019. doi: 10.1016/j.fertnstert.2016.09.019
[13]	邹曜宇, 徐彦, 谷瑞环, 等. 胚胎形态动力学参数与胚胎整倍性的关系[J]. 生殖医学杂志, 2020, 29(10):1275-1279. doi: 10.3969/j.issn.1004-3845.2020.10.004. doi: 10.3969/j.issn.1004-3845.2020.10.004
[14]	郑爱燕, 王玮, 蒲艳, 等. 胚胎发育形态学和动力学特征在胚胎选择中的应用价值[J]. 生殖医学杂志, 2021, 30(5):588-593. doi: 10.3969/j.issn.1004-3845.2021.05.005. doi: 10.3969/j.issn.1004-3845.2021.05.005
[15]	郭颖, 连方, 孙振高, 等. 时差成像培养系统对IVF/ICSI患者早期受精和胚胎发育潜能的影响[J]. 山东医药, 2017, 57(10):74-76. doi: 10.3969/j.issn.1002-266X.2017.10.026. doi: 10.3969/j.issn.1002-266X.2017.10.026
[16]	高洋, 刘军霞, 朱家红, 等. 时差成像系统对囊胚培养及妊娠结局的影响[J]. 生殖医学杂志, 2020, 29(9):1198-1203. doi: 10.3969/j.issn.1004-3845.2020.09.015. doi: 10.3969/j.issn.1004-3845.2020.09.015
[17]	Rubio I, Galán A, Larreategui Z, et al. Clinical validation of embryo culture and selection by morphokinetic analysis: a randomized, controlled trial of the EmbryoScope[J]. Fertil Steril, 2014, 102(5):1287-1294.e5. doi: 10.1016/j.fertnstert.2014.07.738. doi: 10.1016/j.fertnstert.2014.07.738
[18]	纪冰, 马学工, 李斌业, 等. Time-lapse培养与常规培养卵裂期胚胎移植的妊娠及新生儿结局分析[J]. 实用医学杂志, 2020, 36(21):3001-3004. doi: 10.3969/j.issn.1006-5725.2020.21.023. doi: 10.3969/j.issn.1006-5725.2020.21.023
[19]	Mascarenhas M, Fox SJ, Thompson K, et al. Cumulative live birth rates and perinatal outcomes with the use of time-lapse imaging incubators for embryo culture: a retrospective cohort study of 1882 ART cycles[J]. BJOG, 2019, 126(2):280-286. doi: 10.1111/1471-0528.15161. doi: 10.1111/1471-0528.15161 URL
[20]	Kalleas D, McEvoy K, Horne G, et al. Live birth rate following undisturbed embryo culture at low oxygen in a time-lapse incubator compared to a high-quality benchtop incubator[J]. Hum Fertil(Camb), 2022, 25(1):147-153. doi: 10.1080/14647273.2020.1729423. doi: 10.1080/14647273.2020.1729423
[21]	Conaghan J, Chen AA, Willman SP, et al. Improving embryo selection using a computer-automated time-lapse image analysis test plus day 3 morphology: results from a prospective multicenter trial[J]. Fertil Steril, 2013, 100(2):412-419.e5. doi: 10.1016/j.fertnstert.2013.04.021. doi: 10.1016/j.fertnstert.2013.04.021
[22]	Petersen BM, Boel M, Montag M, et al. Development of a generally applicable morphokinetic algorithm capable of predicting the implantation potential of embryos transferred on Day 3[J]. Hum Reprod, 2016, 31(10):2231-2244. doi: 10.1093/humrep/dew188. doi: 10.1093/humrep/dew188 URL
[23]	Cunegatto B, Azambuja R, Hentschke MR, et al. Euploidy rate according to kidscore software (embryoscope plus ®) evaluation tool[J]. Fertil Steril, 2021, 116(3):e159.
[24]	Basile N, Vime P, Florensa M, et al. The use of morphokinetics as a predictor of implantation: a multicentric study to define and validate an algorithm for embryo selection[J]. Hum Reprod, 2015, 30(2):276-283. doi: 10.1093/humrep/deu331. doi: 10.1093/humrep/deu331 URL
[25]	李国臻, 耿亚松, 杨志伟, 等. 时差成像系统对IVF-ET结局的改善及其优选模型初探[J]. 生殖医学杂志, 2021, 30(1):25-29. doi: 10.3969/j.issn.1004-3845.2021.01.005. doi: 10.3969/j.issn.1004-3845.2021.01.005
[26]	石江霞, 张硕屏, 龚斐, 等. 延时摄像在人类辅助生殖技术中的应用[J]. 国际妇产科学杂志, 2013, 40(4):358-363,368.
[27]	Meseguer M, Rubio I, Cruz M, et al. Embryo incubation and selection in a time-lapse monitoring system improves pregnancy outcome compared with a standard incubator: a retrospective cohort study[J]. Fertil Steril, 2012, 98(6):1481-1489.e10. doi: 10.1016/j.fertnstert.2012.08.016. doi: 10.1016/j.fertnstert.2012.08.016
[28]	Insua MF, Cobo AC, Larreategui Z, et al. Obstetric and perinatal outcomes of pregnancies conceived with embryos cultured in a time-lapse monitoring system[J]. Fertil Steril, 2017, 108(3):498-504. doi: 10.1016/j.fertnstert.2017.06.031. doi: 10.1016/j.fertnstert.2017.06.031 URL
[29]	Racowsky C, Martins WP. Effectiveness and safety of time-lapse imaging for embryo culture and selection: it is still too early for any conclusions?[J]. Fertil Steril, 2017, 108(3):450-452. doi: 10.1016/j.fertnstert.2017.07.1156. doi: 10.1016/j.fertnstert.2017.07.1156 URL