Non-invasive embryo selection strategy for clinical IVF to avoid wastage of potentially competent embryos

作者:Chen, Li; Li, Wen; Liu, Yuxiu; Peng, Zhihang; Cai, Liyi; Zhang, Ningyuan; Xu, Juanjuan; Wang, Liang; Teng, Xiaoming; Yao, Yaxin; Zou, Yangyun; Ma, Menglin; Liu, Jianqiao; Lu, Sijia*; Sun, Haixiang*; Yao, Bing*
来源:REPRODUCTIVE BIOMEDICINE ONLINE, 2022, 45(1): 26-34.
DOI:10.1016/j.rbmo.2022.03.006

摘要

Research question: Can a non-invasive embryo transfer strategy provide a reference for embryo selection to be established? @@@ Design: Chromosome sequencing of 345 paired blastocyst culture medium and whole blastocyst samples was carried out and a non-invasive embryo grading system was developed based on the random forest machine learning algorithm to predict blastocyst ploidy. The system was validated in 266 patients, and a blinded prospective observational study was conducted to investigate clinical outcomes between machine learning-guided and traditional non-invasive preimplantation genetic testing for aneuploidy (niPGT-A) analyses. Embryos were graded as A, B or C according to their euploidy probability levels predicted by non-invasive chromosomal screening (NICS). @@@ Results: Higher live birth rate was observed in A- versus C-grade embryos (50.4% versus 27.1%, P = 0.006) and B- versus C-grade embryos (45.3% versus 27.1%, P = 0.022) and lower miscarriage rate in A- versus C-grade embryos (15.9% versus 33.3%, P = 0.026) and B- versus C-grade embryos (14.3% versus 33.3%, P = 0.021). The embryo utilization rate was significantly higher through the machine learning strategy than the conventional dichotomic judgment of euploidy or aneuploidy in the niPGT-A analysis (78.8% versus 57.9%, P < 0.001). Better outcomes were observed in A- and B-grade embryos versus C-grade embryos and higher embryo utilization rates through the machine learning strategy compared with traditional niPGT-A analysis. @@@ Conclusion: A machine learning guided embryo grading system can be used to optimize embryo selection and avoid wastage of potential embryos.

  • 单位
    同济大学; 南京大学; 广州医学院; 南方医科大学; 1