时差筛选技术KIDscore D5算法作为胚胎形态学评估和PGT-A(胚胎植入前非整倍体遗传学检测)的辅助工具
发布时间:2020-12-21 19:07:13

为了评估已经植入胚胎的数据算法KID Score D5作为非整倍性的形态学评估和胚胎植入前非整倍体遗传学检测(PGT-A)的辅助工具,以改善着床率和继续妊娠率,做了如下研究,以下为部分原文和译文:

KIDscoreTM D5 algorithm as an additional tool to morphologic assessment and PGT-A for embryo selection: a time-lapse Study

E Gazzo1, F Pe?a1, F Valdéz2, S Sessarego1, A Chung1,C Bonomini1, M Ascenzo1, M Velit1, E Escudero1

1INMATER Fertility Clinic, Lima, Peru. 2GENOMICS PERú, Lima, Peru.

Objective: To evaluate the use of the known implantation data algorithm KIDscoreTM D5 (Vitrolife?, Canadá) as an additional tool to morphologic assessment and preimplantation genetic testing for aneuploidies (PGT-A) to improve implantation and ongoing pregnancy rates.

Methods: Design: Retrospective Cohort Study. A total of 912 embryos from 270 patients that underwent an IVF treatment at INMATER Fertility Clinic in Lima - Perú, between October 2016 and June 2018, were analyzed. All embryos were cultured for up to 5 or 6 days in the Embryoscope? time-lapse incubator (Vitrolife?, Canada) and evaluated using the KIDscore TM D5 algorithm (KS5). 778 (85.31%) of these embryos were also biopsied for PGT-A screening. A total of 184 single embryo transfers (68% of patients), were performed during this period and the embryos transferred were classified into four groups: 1) Euploid embryos transferred without considering their KS5 score in the selection process (n=86), 2) Euploid embryos transferred considering their KS5 score in the selection process (n=48), 3) Embryos transferred without considering their KS5 score in the selection process and that were not evaluated by PGT-A (n=40) and 4) Embryos transferred considering their KS5 score in the selection process and that were not evaluated by PGT-A (n=10). Implantation and ongoing pregnancy rates were compared between the groups and between euploid embryos with the highest/ best KS5 score (KS5=6, n=25) and euploid embryos with the lowest/worst KS5 score (KS5=1, n=51). Correlation between KS5 score and embryo euploidy rate was also evaluated.

Results: Implantation rate and ongoing pregnancy rates was found to be significantly higher in euploid embryo transfers when taking into account their KS5 score in the embryo selection process compared to euploid embryo transfers where selection was based on morphology (75.00% vs. 50.00%; p=0.002 and 66.66% vs 48.83%; p=0.037 respectively). Additionally, implantation rates were significantly  higher for blastocysts with highest KS5 score (KS5=6) compared to lowest (KS5=1) (80.00% vs. 49.02%; p=0.045), and ongoing pregnancy rates was not found with significantly (72.00% vs 47.06%; p=0.105). Euploidy rate was significantly higher in the group of embryos with KS5=6 than in the group of embryos with KS5=1 (61.88% vs. 48.33%;p=0.006).

Conclusion: Embryo selection by the use of the KS5 algorithm score improves implantation rates of single euploid blastocysts transfers. Furthermore, embryos with the highest KS5 score have a higher probability of being euploid and implanting.

时差筛选技术KIDscore D5算法作为胚胎形态学评估和PGT-A(胚胎植入前非整倍体遗传学检测)的辅助工具

摘要:评估已经植入胚胎的数据算法KID Score D5作为非整倍性的形态学评估和胚胎植入前非整倍体遗传学检测(PGT-A)的辅助工具,以改善着床率和继续妊娠率?;毓诵匝芯?,分析了201610月至20186月间在秘鲁利马INMATER生殖中心进行IVF治疗的270名患者的912个胚胎。所有胚胎在时差监测培养箱中培养56天,使用KID Score D5算法(KS5)进行评估,有77885.31%)个胚胎进行了PGT-A活检筛选,总共184次单胚胎移植(68%的患者),进行移植的胚胎分为四组:1)整倍体胚胎,没有考虑其KS5得分(n = 86),2)考虑KS5得分,选择整倍体胚胎(n = 48),3)未考虑KS5得分,未通过PGT-An = 40),4)考虑KS5得分,但未通过PGT-A评估(n = 10)。比较两组间着床率和继续妊娠率,即KS5评分最高/最好的整倍体胚胎(KS5=6, n=25)KS5评分最低/最坏的整倍体胚胎(KS5=1, n=51)。研究KS5评分与胚胎整倍率的相关性。结果发现,在整倍体胚胎移植中,当考虑到胚胎的KS5分数移植时,相较于基于形态学数据进行胚移植时,前者的着床率和继续妊娠率(75.00%vs 50.00%;p = 0.00266.66% vs 48.83%;p = 0.037)都明显更高,具有显著差异。此外,KS5最高得分(KS5 = 6)与最低(KS5 = 1)的囊胚, 着床率为(80.00%vs 49.02%; p = 0.045)也具有显著差异,但继续妊娠率(72.00% vs 47.06%; p = 0.105)未发现显著性差异。同时,KS5 = 6的胚胎和KS5 = 1的胚胎,整倍体率分别(61.88% vs 48.33%; p = 0.006),前者的整倍体率明显更高,具有显著差异。结论,使用KS5算法的评分选择胚胎可提高单个整倍体囊胚移植的着床率。此外,KS5分数最高的胚胎更有可能有更高的整倍体率和着床率。


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