Abstract:
Endometriosis has been shown to be associated with unfavorable development and maturation of oocytes, as well as aberrancies in embryonal development, including arrest after fertilization, following in vitro fertilization (IVF). Time-lapse monitoring (TLM) enables continuous and non-invasive monitoring of embryo morphokinetics during the IVF process and might be useful in the assessment of embryos from women with endometriosis. In this review, five eligible studies were evaluated to determine if embryo morphokinetics assessed under TLM differ in patients with endometriosis and subsequently predict blastocyst quality, implantation and success of pregnancy. The studies showed overall inferior morphokinetic parameters of embryos from endometriosis patients when compared to controls, independent of the severity of endometriosis. Embryos with optimal early morphokinetic parameters (t2, s2, t5, tSB, tEB) and late developmental events (compaction, morulation, and blastulation) had better implantation rates than those who had suboptimal ranges. However, due to few studies available with mostly retrospective data, the validity of these findings and their generalizability for clinical practice needs to be further assessed. Prospective studies with larger sample sizes are needed to determine whether using TLM for embryo selection in endometriosis improves pregnancy and live birth outcomes.
摘要:
子宫内膜异位症已被证明与卵母细胞的发育和成熟有关。以及胚胎发育的异常,包括受精后的逮捕,体外受精(IVF)。延时监测(TLM)可以在IVF过程中对胚胎形态动力学进行连续和非侵入性监测,并且可能有助于评估子宫内膜异位症女性的胚胎。在这次审查中,对5项符合条件的研究进行了评估,以确定子宫内膜异位症患者在TLM下评估的胚胎形态动力学是否不同,并随后预测胚泡质量。植入和成功怀孕。研究表明,与对照组相比,子宫内膜异位症患者胚胎的形态动力学参数总体较差,与子宫内膜异位症的严重程度无关。具有最佳早期形态动力学参数的胚胎(t2,s2,t5,tSB,tEB)和晚期发育事件(压实,malulation,和囊胚形成)的着床率高于次优范围的着床率。然而,由于很少有研究主要是回顾性数据,这些发现的有效性及其在临床实践中的普遍性需要进一步评估.需要更大样本量的前瞻性研究来确定使用TLM进行子宫内膜异位症的胚胎选择是否可以改善妊娠和活产结局。