Embryo morphokinetics is potentially associated with clinical outcomes of single-embryo transfers in preimplantation genetic testing for aneuploidy cycles

被引:42
作者
Lee, Chun-I [1 ,2 ,3 ]
Chen, Chien-Hong [3 ]
Huang, Chun-Chia [3 ]
Cheng, En-Hu [3 ]
Chen, Hsiu-Hui [3 ]
Ho, Su-Ting [3 ]
Lin, Pin-Yao [1 ,3 ]
Lee, Maw-Sheng [1 ,2 ,3 ]
Lee, Tsung-Hsien [1 ,2 ,3 ,4 ]
机构
[1] Chung Shan Med Univ, Inst Med, Taichung, Taiwan
[2] Chung Shan Med Univ Hosp, Dept Obstet & Gynecol, Taichung, Taiwan
[3] Lee Womens Hosp, Div Infertil, Taichung, Taiwan
[4] Natl Taiwan Univ, Dept Obstet & Gynecol, Coll Med, Taipei, Taiwan
关键词
High-resolution next-generation sequencing; Morphokinetics; Preimplantation genetic testing for aneuploidy; Single-embryo transfer; Time-lapse algorithms; LAPSE; IMPLANTATION; SELECTION; BLASTULATION; BLASTOCYSTS; PREDICTOR; SYSTEM;
D O I
10.1016/j.rbmo.2019.05.020
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Research question: Are the morphokinetics of euploid blastocysts evaluated by a generally applicable algorithm associated with the clinical outcomes of single-embryo transfer (SET)? Design: Time-lapse microscopy was used to compare morphokinetic variables between expanded blastocysts derived from preimplantation genetic testing for aneuploidy cycles using high-resolution next-generation sequencing (hr-NGS). The clinical efficacy of the morphokinetic algorithm KIDScore D5 was evaluated after euploid SET. Results: Compared with euploid blastocysts, low-level mosaic blastocysts presented comparable morphokinetic and morphological features. However, high-level mosaic blastocysts exhibited significant delays in t5 (median 51.9 h post insemination (hpi), P = 0.034) (where t is the time for the embryo to reach the specific stage in hours after ICSI or conventional IVF) and t8 (median 58.6 hpi, P = 0.032) accompanied by a prolonged time period for the third cell cycle (median 14.7 h, P = 0.012). A significantly higher incidence (P = 0.011) of multinucleation indicated a susceptibility of high-level mosaic blastocysts to mitotic errors. Only a delay in the time for the embryo to reach the full blastocyst stage (median 106.0 hpi, P = 0.039) was revealed in aneuploid blastocysts, reflecting the reduced formation of good-quality blastocysts (42.6% versus 65.7%, P < 0.001). Euploid blastocysts with specific morphokinetic characteristics were graded using the KIDScore D5 algorithm. Grade C embryos achieved significantly lower rates of clinical pregnancy, implantation and ongoing pregnancy (25%, 25% and 10%, respectively) compared with the grade A (76.2%, 79.4% and 68.3%, respectively) or grade B (62.5%, 66.7% and 62.5%, respectively) embryos (P = 0.0171 to <0.0001). Conclusions: Although morphokinetic features appear dissimilar in embryos with different diploid-aneuploid mosaic levels, predicting chromosomal abnormalities using morphokinetics alone is still insufficient. When combined with hr-NGS, use of the generally applicable KIDScore D5 algorithm has the potential to discriminate euploid blastocysts with different developmental competence.
引用
收藏
页码:569 / 579
页数:11
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