PDF(Pubmed)
Abstract：
BACKGROUND: The occurrence of blastocyst collapse may become an indicator of preimplantation embryo quality assessment. It has been reported that collapsing blastocysts can lead to higher rates of aneuploidy and poorer clinical outcomes, but more large-scale studies are needed to explore this relationship. This study explored the characteristics of blastocyst collapse identified and quantified by artificial intelligence and explored the associations between blastocyst collapse and embryo ploidy, morphological quality, and clinical outcomes.
METHODS: This observational study included data from 3288 biopsied blastocysts in 1071 time-lapse preimplantation genetic testing cycles performed between January 2019 and February 2023 at a single academic fertility center. All transferred blastocysts are euploid blastocysts. The artificial intelligence recognized blastocyst collapse in time-lapse microscopy videos and then registered the collapsing times, and the start time, the recovery duration, the shrinkage percentage of each collapse. The effects of blastocyst collapse and embryo ploidy, pregnancy, live birth, miscarriage, and embryo quality were studied using available data from 1196 euploid embryos and 1300 aneuploid embryos.
RESULTS: 5.6% of blastocysts collapsed at least once only before the full blastocyst formation (tB), 19.4% collapsed at least once only after tB, and 3.1% collapsed both before and after tB. Multiple collapses of blastocysts after tB (times ≥ 2) are associated with higher aneuploid rates (54.6%, P > 0.05; 70.5%, P < 0.001; 72.5%, P = 0.004; and 71.4%, P = 0.049 in blastocysts collapsed 1, 2, 3 or ≥ 4 times), which remained significant after adjustment for confounders (OR = 2.597, 95% CI 1.464-4.607, P = 0.001). Analysis of the aneuploid embryos showed a higher ratio of collapses and multiple collapses after tB in monosomies and embryos with subchromosomal deletion of segmental nature (P < 0.001). Blastocyst collapse was associated with delayed embryonic development and declined blastocyst quality. There is no significant difference in pregnancy and live birth rates between collapsing and non-collapsing blastocysts.
CONCLUSIONS: Blastocyst collapse is common during blastocyst development. This study underlined that multiple blastocyst collapses after tB may be an independent risk factor for aneuploidy which should be taken into account by clinicians and embryologists when selecting blastocysts for transfer.
METHODS: This observational study included data from 3288 biopsied blastocysts in 1071 time-lapse preimplantation genetic testing cycles performed between January 2019 and February 2023 at a single academic fertility center. All transferred blastocysts are euploid blastocysts. The artificial intelligence recognized blastocyst collapse in time-lapse microscopy videos and then registered the collapsing times, and the start time, the recovery duration, the shrinkage percentage of each collapse. The effects of blastocyst collapse and embryo ploidy, pregnancy, live birth, miscarriage, and embryo quality were studied using available data from 1196 euploid embryos and 1300 aneuploid embryos.
RESULTS: 5.6% of blastocysts collapsed at least once only before the full blastocyst formation (tB), 19.4% collapsed at least once only after tB, and 3.1% collapsed both before and after tB. Multiple collapses of blastocysts after tB (times ≥ 2) are associated with higher aneuploid rates (54.6%, P > 0.05; 70.5%, P < 0.001; 72.5%, P = 0.004; and 71.4%, P = 0.049 in blastocysts collapsed 1, 2, 3 or ≥ 4 times), which remained significant after adjustment for confounders (OR = 2.597, 95% CI 1.464-4.607, P = 0.001). Analysis of the aneuploid embryos showed a higher ratio of collapses and multiple collapses after tB in monosomies and embryos with subchromosomal deletion of segmental nature (P < 0.001). Blastocyst collapse was associated with delayed embryonic development and declined blastocyst quality. There is no significant difference in pregnancy and live birth rates between collapsing and non-collapsing blastocysts.
CONCLUSIONS: Blastocyst collapse is common during blastocyst development. This study underlined that multiple blastocyst collapses after tB may be an independent risk factor for aneuploidy which should be taken into account by clinicians and embryologists when selecting blastocysts for transfer.
摘要：
背景：胚泡塌陷的发生可能成为植入前胚胎质量评估的指标。据报道，囊胚塌陷可导致更高的非整倍体率和较差的临床结果，但是需要更多的大规模研究来探索这种关系。这项研究探索了通过人工智能识别和量化的胚泡塌陷的特征，并探索了胚泡塌陷与胚胎倍性之间的关联。形态质量，和临床结果。
方法：这项观察性研究包括了在2019年1月至2023年2月期间在一个学术生育中心进行的1071个延时植入前基因检测周期中的3288个活检胚泡的数据。所有转移的胚泡是整倍体胚泡。人工智能在延时显微镜视频中识别胚泡塌陷，然后记录塌陷时间，和开始时间，恢复持续时间，每次塌陷的收缩率。囊胚塌陷和胚胎倍性的影响，怀孕,活产,流产,使用1196个整倍体胚胎和1300个非整倍体胚胎的可用数据研究了胚胎质量。
结果：5.6%的囊胚仅在完整囊胚形成（tB）之前至少塌陷一次，19.4%仅在tB后至少崩溃一次，在tB之前和之后，3.1%的人崩溃了。在tB（时间≥2）后囊胚的多次塌陷与较高的非整倍体率（54.6％，P>0.05;70.5%,P<0.001;72.5%,P=0.004;和71.4%,囊胚塌陷1、2、3或≥4次，P=0.049），校正混杂因素后仍然显著(OR=2.597，95%CI1.464-4.607，P=0.001)。非整倍体胚胎的分析显示，在tB后，在具有节段性亚染色体缺失的单体和胚胎中，塌陷和多次塌陷的比率更高（P<0.001）。囊胚塌陷与胚胎发育延迟和囊胚质量下降有关。塌陷和非塌陷胚泡之间的妊娠率和活产率没有显着差异。
结论：囊胚塌陷在囊胚发育过程中很常见。这项研究强调，tB后多个胚泡塌陷可能是非整倍性的独立危险因素，临床医生和胚胎学家在选择胚泡进行移植时应予以考虑。
方法：这项观察性研究包括了在2019年1月至2023年2月期间在一个学术生育中心进行的1071个延时植入前基因检测周期中的3288个活检胚泡的数据。所有转移的胚泡是整倍体胚泡。人工智能在延时显微镜视频中识别胚泡塌陷，然后记录塌陷时间，和开始时间，恢复持续时间，每次塌陷的收缩率。囊胚塌陷和胚胎倍性的影响，怀孕,活产,流产,使用1196个整倍体胚胎和1300个非整倍体胚胎的可用数据研究了胚胎质量。
结果：5.6%的囊胚仅在完整囊胚形成（tB）之前至少塌陷一次，19.4%仅在tB后至少崩溃一次，在tB之前和之后，3.1%的人崩溃了。在tB（时间≥2）后囊胚的多次塌陷与较高的非整倍体率（54.6％，P>0.05;70.5%,P<0.001;72.5%,P=0.004;和71.4%,囊胚塌陷1、2、3或≥4次，P=0.049），校正混杂因素后仍然显著(OR=2.597，95%CI1.464-4.607，P=0.001)。非整倍体胚胎的分析显示，在tB后，在具有节段性亚染色体缺失的单体和胚胎中，塌陷和多次塌陷的比率更高（P<0.001）。囊胚塌陷与胚胎发育延迟和囊胚质量下降有关。塌陷和非塌陷胚泡之间的妊娠率和活产率没有显着差异。
结论：囊胚塌陷在囊胚发育过程中很常见。这项研究强调，tB后多个胚泡塌陷可能是非整倍性的独立危险因素，临床医生和胚胎学家在选择胚泡进行移植时应予以考虑。
