摘要
目的建立依据时差培养技术的胚胎发育动力学参数模型,并评估模型在预测优质囊胚中的价值。方法选取2021年10月至2022年6月在海南现代妇女儿童医院生殖医学科行体外受精-胚胎移植(IVF-ET)助孕的300例不孕女性患者(共1000枚胚胎)作为研究对象。采用时差培养技术对胚胎进行体外培养,记录胚胎发育过程中各项动力学参数,根据形态学评分进行囊胚选择后进行胚胎移植。根据优质囊胚数分为优质囊胚组(n=74)和对照组(n=384),对比两组胚胎发育动力学参数,采用多因素Logistic回归方程分析差异因素,采用R语言建立列线图模型,采用受试者工作特征(ROC)曲线评估模型早期预测优质囊胚形成的内部效能。结果优质囊胚组tPNa多于对照组,tPB2、t2、t3、t4、t5、cc2均少于对照组,差异具有统计学意义(P<0.05);多因素Logistic回归分析显示,tPNa(OR=1.396)是优质囊胚形成的独立危险因素(P<0.05),tPB2(OR=0.373)、t3(OR=0.939)、t4(OR=0.937)、cc2(OR=0.805)是优质囊胚形成的独立保护因素(P<0.05);ROC曲线分析显示,以独立相关因素构建优质囊胚形成的列线图模型早期预测优质囊胚形成的曲线下面积(AUC)为0.894,灵敏度为74.32%,特异度为91.67%。结论时差培养技术可以通过观察胚胎发育过程中的动力学参数来早期预测优质囊胚的形成,可在减少胚胎移植数量的基础上保证临床妊娠结局。
Objective To establish of an embryo development dynamics parameter model based on time-difference culture technology and evaluate the value of the model in predicting high-quality blastocysts.Methods A total of 300 infertile female patients(1000 embryos)undergoing in vitro fertilization-embryo transfer(IVF-ET)assisted pregnancy in Department of Reproductive Medicine of Hainan Modern Women′s and Children′s Hospital from October 2021 to June 2022 were selected as study objects.Embryos were cultured in vitro using the time-difference culture technology,and the dynamic parameters during the embryo development were recorded.Embryo transfer is performed after selecting blastocysts based on morphological scores.According to the number of high-quality blastocysts,they were divided into high-quality blastocysts group(n=74)and control group(n=384).The dynamic parameters of embryonic development between the two groups were compared,and multivariate Logistic regression equation was used to analyze the differences factors.The nomogram model was established using R language,and the receiver operating characteristic(ROC)curve evaluation model was used to predict the internal efficiency of high-quality blastocyst formation at an early stage.Results The tPNa of the high-quality blastocyst group was higher than that of the control group,and the levels of tPB2,t2,t3,t4,t5,and cc2 were lower than those of the control group,with statistical significance(P<0.05).Multivariate Logistic regression analysis showed that tPNa(OR=1.396)was an independent risk factor for high-quality blastocyst formation(P<0.05),while tPB2(OR=0.373),t3(OR=0.939),t4(OR=0.937),and cc2(OR=0.805)were independent protective factors for high-quality blastocyst formation(P<0.05).The analysis of ROC curve showed that the area under curve(AUC)of the nomograph model of high-quality blastocyst formation based on independent related factors was 0.894,the sensitivity was 74.32%,and the specificity was 91.67%.Conclusions The time-difference culture technology can predict high-quality blastocyst formation at early stage by observing the dynamics parameters during embryo development and ensure clinical pregnancy outcome based on reducing the number of embryos transferred.
作者
李林江
云日明
王杰优
孙少青
蒋伟民
徐媛媛
LI Linjiang;YUN Riming;WANG Jieyou;SUN Shaoqing;JIANG Weimin;XU Yuanyuan(Department of Reproductive Medicine,Hainan Modern Women′s and Children′s Hospital,Haikou 571100,Hainan,China)
出处
《中国性科学》
2024年第4期37-41,共5页
Chinese Journal of Human Sexuality
基金
海南省卫生健康行业科研项目(21A200413)。
关键词
时差培养
体外受精-胚胎移植
动力学参数
预测模型
Time-difference culture
In vitro fertilization-embryo transfer
Dynamics parameters
Prediction model
