基于第3天胚胎培养液340 nm处吸光度建立优质胚胎预测模型及验证  

Establishment and validation of embryo high-quality prediction models based on the third-day 340 nm absorbance embryo culture

作　　者：周超 庾广聿[1] 范嘉琪 于春梅 吴敏 陈施蓓 Zhou Chao;Yu Guangyu;Fan Jiaqi;Yu Chunmei;Wu Min;Chen Shibei(Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin 541000,Guangxi Zhuang Autonomous Region,China;Changzhou Maternal and Child Health Hospital,Changzhou 213000,Jiangsu Province,China)

机构地区：[1]广西壮族自治区南溪山医院,广西壮族自治区桂林市541000 [2]常州市妇幼保健院,江苏省常州市213000

出　　处：《中国组织工程研究》2024年第7期1050-1056,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:既往大量研究证实,高浓度代谢产物与胚胎质量及临床结局具有显著相关性,而且胚胎发育沉默理论表明正常发育胚胎体外培养时与外界保持较低的物质交换水平,而当胚胎出现DNA损伤时常因应激修复机制而表现出代谢异常活跃状态。目的:基于第3天胚胎培养液340 nm处吸光度建立优质胚胎预测模型及验证,为更客观而准确的胚胎质量评估提供依据。方法:回顾性分析2019年11月至2021年12月于广西壮族自治区南溪山医院接受体外受精-胚胎移植患者269例,其中162例于第3天形成优质胚胎873枚,优质囊胚214枚,将其纳入优质胚胎组;107例于第3天形成非优质胚胎859枚,非优质囊胚214枚,将其纳入非优质胚胎组;采用朗伯-比尔定律筛选出对优质与非优质胚胎具有区分度的特征波长,分析其与优质胚胎的相关性及影响趋势,并建立该波长下吸光度对优质与非优质胚胎的临床预测模型并验证。结果与结论:(1)第3天优质与非优质胚胎培养液于340 nm处吸光度差异有显著性意义(P<0.001),且与第3天优质胚胎的形成呈负相关性(r=-0.486,P<0.001);优质与非优质囊胚在培养液340 nm处吸光度差异有显著性意义(P<0.05),且与优质囊胚的形成呈负相关性(r=-0.642,P<0.001);(2)受试者工作曲线分析显示,第3天优质与非优质胚胎培养液于340 nm处吸光度的最佳截断值为0.235,曲线下面积为0.799,敏感度为62.9%、特异度为78.0%、准确度为70.5%;优质与非优质囊胚培养液于340 nm处吸光度的最佳截断值为0.175,曲线下面积为0.871,敏感度为74.3%、特异度为89.1%、准确度为82.2%;(3)限制性立方样条曲线分析显示,当培养液340 nm处吸光度≥0.221时,对第3天非优质胚胎的形成具有显著的正影响趋势,当培养液340 nm处吸光度≥0.160时,对非优质囊胚的形成具有显著的正影响趋势;(4)临床决策曲线与临床影响曲线显示,培养液340 nm处吸光度对�BACKGROUND:A large number of previous studies have confirmed that a high concentration of metabolites is significantly correlated with embryo quality and clinical outcome,and the theory of silencing embryo development indicates that normally developed embryos maintain a low level of material exchange with the outside world during in vitro culture,while embryos often show abnormal metabolic activity due to stress repair mechanism when DNA damage occurs.OBJECTIVE:To establish and verify an embryo quality prediction model based on the third-day 340 nm absorbance embryo cultures to provide the basis for a more objective and accurate embryo quality assessment.METHODS:269 patients at the Nanxishan Hospital of Guangxi Zhuang Autonomous Region for in vitro fertilization and embryo transplantation from November 2019 to December 2021 were retrospectively analyzed.Among them,on day 3,162 cases who had 873 optimal embryos and 214 high-quality blastocysts were included in the high-quality embryo group.On day 3,107 cases who had 859 non-optimal embryos and 214 non-high-quality blastocysts were included in the non-high-quality embryo group.Lambert-beer law was used to screen out the characteristic wavelength with distinguishing degree between superior and non-superior embryos,analyze its correlation and influence trend with high-quality embryos,and establish the clinical prediction model and validation of absorbance for high-quality and non-high-quality embryos at this wavelength.RESULTS AND CONCLUSION:(1)There was a significant difference in absorbance between high-quality and non-high-quality embryos at 340 nm on day 3(P<0.001),and a negative correlation was found with the formation of high-quality embryos on day 3(r=-0.486,P<0.001).The absorbance of high-quality and non-high-quality blastocyst at 340 nm was significantly different(P<0.05),and was negatively correlated with the formation of high-quality blastocyst(r=-0.642,P<0.001).(2)The optimal cut-off value of absorbance at 340 nm between high-quality and non-high-quality

关 键 词：胚胎质量评估 胚胎代谢组学 胚胎形态学评估 预测模型 优质胚胎 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R321-33