河北医学2024，Vol.30Issue(9)：1499-1505,7.DOI:10.3969/j.issn.1006-6233.2024.09.016
胚胎形态动力学参数在胚胎整倍体预测模型构建中的应用研究
Application of Embryo Morphokinetic Parameters in the Construction of Embryonic Prediction Model
摘要
Abstract
Objective:To establish a prediction model for euploidy based on embryo morphokinetic pa-rameters,so as to provide a reference for evaluating embryonic developmental potential in assisted reproductive technology.Methods:A retrospective analysis was performed on the clinical data of patients who underwent pre-implantation genetic testing between December 2020 and June 2023.A total of 1383 available blastocysts from 364 cycles were included.According to euploidy,the blastocysts were divided into the euploidy group(442 blastocysts)and the non-euploidy group(941 blastocysts).The morphokinetic parameters of the two groups were compared,and multivariate logistic regression analysis was performed.A prediction model for eu-ploidy was constructed.The ROC curve was used to analyze the sensitivity and specificity of the prediction model.Meanwhile,morphokinetic parameters of 658 available blastocysts from 215 cycles included from July 2023 to April 2024 were used for clinical validation.The consistency between the prediction model and clini-cal practice was analyzed.Results:t4,t5,s2,time of starting blastulation(tSB),time of hatching blastocyst(tHB),and tHB-tSB in the euploidy group were shorter than those in the non-euploidy group(P<0.05).Logistic regression analysis found that t4,t5,s2,tSB,tHB,and tHB-tSB were influencing factors of blasto-cyst euploidy(P<0.05).A prediction model for euploidy was constructed as follows:P==ex/(1+ex),X=-3.299-0.026×t4-0.018×t5-0.264×s2-0.009×tSB-0.007×tHB-0.153×tHB-tSB.Hosmer-Lemeshow goodness of fit test showed that the prediction model had good goodness of fit(χ2=8.700,P=0.368).The area under the ROC curve of the prediction model was 0.871(95%CI=0.852～0.889,P<0.001).Its sensi-tivity and specificity were 75.86%and 82.11%.Clinical validation indicated that the accuracy of the predic-tion model was 79.94%.The consistency between the prediction model and clinical practice was moderate(Kappa=0.561).Conclusion:Embryo morphokinetic parameters(t4,t5,s2,tSB,tHB and tHB-tSB)are related to the formation of euploidy.The prediction model constructed based on embryo morphokinetic parame-ters in this study is of high value in predicting embryo euploidy and can provide a reference for evaluating em-bryonic developmental potential.关键词
整倍体/胚胎植入前遗传学检测/形态动力学/预测模型Key words
Euploidy/Pre-implantation genetic testing/Morphokinetics/Prediction model引用本文复制引用
金真真,魏泽锋,于春娜,牛学英,王文华,胡艳芬,马亚兰,王雪楠..胚胎形态动力学参数在胚胎整倍体预测模型构建中的应用研究[J].河北医学,2024,30(9):1499-1505,7.基金项目
山东省自然科学基金青年项目,(编号:ZR2023QH478) （编号:ZR2023QH478）
济宁市重点研发计划,(编号:2023YXNS099,2023YXNS228) （编号:2023YXNS099,2023YXNS228）
