Abstract:
Embryo morphology assessment performs relatively poorly in predicting implantation. Embryo aneuploidy screening (PGS) has recently improved, but its clinical value is still debated, and the development of a cheap non-invasive method for the assessment of embryo ploidy status is a highly desirable goal. The growing implementation of time-lapse devices led some teams to test the effectiveness of morphokinetic parameters as predictors of embryo ploidy, with conflicting results. The aim of this study was to conduct a comprehensive review of the literature on the predictive value of morphokinetic parameters for embryo ploidy status. A systematic search on PubMed was conducted using the following key words: time-lapse, morphokinetic, aneuploidy, IVF, preimplantation genetic screening, PGS, chromosomal status. A total of 13 studies were included in the analysis. They were heterogeneous in design, patients, day of embryo biopsy, statistical approach and outcome measures. No single or combined morphokinetic parameter was consistently identified as predictive of embryo ploidy status. In conclusion, the available studies are too heterogeneous for firm conclusions to be drawn on the predictive value of time-lapse analysis for embryo aneuploidy screening. Hence, morphokinetic parameters should not be used yet as a surrogate for PGS to determine embryo ploidy in vitro.
摘要:
胚胎形态评估在预测植入方面表现相对较差。胚胎非整倍体筛查(PGS)最近有所改善,但其临床价值仍有争议,并且开发一种廉价的非侵入性方法来评估胚胎倍性状态是一个非常理想的目标。延时装置的日益普及,导致一些团队测试形态动力学参数作为胚胎倍性预测因子的有效性,结果相互矛盾。这项研究的目的是对形态动力学参数对胚胎倍性状态的预测价值的文献进行全面回顾。在PubMed上进行了系统的搜索,使用以下关键字:延时,形态动力学,非整倍体,IVF,植入前遗传筛查,PGS,染色体状态。共有13项研究纳入分析。他们在设计上是异质的,病人,胚胎活检日,统计方法和结果衡量标准。没有单一或组合的形态动力学参数被一致地鉴定为胚胎倍性状态的预测。总之,现有研究的异质性太大,无法得出延时分析对胚胎非整倍体筛查的预测价值的确切结论.因此,形态动力学参数不应用作PGS的替代指标,以确定体外胚胎倍性。