Application of morphokinetics combined with meiotic spindle observations in cleavage-stage embryo selection
Objective:To explore the embryo selection algorithm involving both morphokinetics and meiotic spindle(MS)morphology for assessing embryonic developmental potential.Methods:The clinical data of 46 cycles of patients who underwent intracytoplasmic sperm injection(ICSI)in the Center of Reproduction and Genetics of Suzhou Municipal Hospital from August 2020 to June 2022 with MS observation and time-lapse monitoring were retrospectively analyzed.The data of oocytes and cleavage stage embryos were divided into groups according to MS morphology,the occurrence of abnormal cleavage and embryonic morphology.The effects of morphokinetic parameters and MS morphology on embryonic developmental potential were analyzed to establish the embryo selection algorithm for predicting blastocyst formation,and to explore the predictive value of the algorithm using the receiver operating characteristic(ROC)curve.Results:The blastocyst formation rate in the MS normal group was significantly higher than that in the MS abnormal group(63.6％vs.46.9％,P＜0.05).The blastocyst formation rate of the direct division(DC)1 group was significantly lower than those of the DC2 group and the non-DC group(5.0％vs.46.7％and 63.9％,P＜0.05).The blastocyst formation rate of D3 morphology high-quality embryos was significantly higher than that of D3 morphology non-high-quality embryos(79.4％vs.24.6％,P＜0.05).Using multiple logistic regression analysis,it was found that,in D3 morphological high-quality embryos,the development duration from 3 cells to 5 cells(cc3)and that from 5 cells to 8 cells(s3)as well as MS morphology had a predictive value for blastocyst formation(P＜0.05).In D3 morphological non-high-quality embryos,the number of blastomere had a predictive value for blastocyst formation(P＜0.05).Based on these results,the D3 embryo selection algorithm was established with eleven levels(A-K),in which level A was the best and level K was the worst.The ROC curve for blastocyst formation from this selection algorithm showed an area under the curve of 0.857[95％CI(0.816,0.899),P=0.000].Conclusions:The D3 embryo selection algorithm which combined morphokinetics with MS morphology analysis has a better prediction for the embryo development potential.
万方数据
维普
