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為了評估已經植入胚胎的數據算法KID Score D5作為非整倍性的形態學評估和胚胎植入前非整倍體遺傳學檢測（PGT-A）的輔助工具，以改善著床率和繼續妊娠率，做了如下研究，以下為部分原文和譯文：
KIDscoreTM D5 algorithm as an additional tool to morphologic assessment and PGT-A for embryo selection: a time-lapse Study
E Gazzo1, F Peña1, 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.
摘要：評估已經植入胚胎的數據算法KID Score D5作為非整倍性的形態學評估和胚胎植入前非整倍體遺傳學檢測（PGT-A）的輔助工具，以改善著床率和繼續妊娠率。回顧性研究，分析了2016年10月至2018年6月間在秘魯利馬INMATER生殖中心進行IVF治療的270名患者的912個胚胎。所有胚胎在時差監測培養箱中培養5或6天，使用KID Score D5算法（KS5）進行評估，有778（85.31％）個胚胎進行了PGT-A活檢篩選，總共184次單胚胎移植（68％的患者），進行移植的胚胎分為四組：1）整倍體胚胎，沒有考慮其KS5得分（n = 86），2）考慮KS5得分，選擇整倍體胚胎（n = 48），3）未考慮KS5得分，未通過PGT-A（n = 40），4）考慮KS5得分，但未通過PGT-A評估（n = 10）。比較兩組間著床率和繼續妊娠率，即KS5評分最高/最好的整倍體胚胎(KS5=6, n=25)與KS5評分最低/最壞的整倍體胚胎(KS5=1, n=51)。研究KS5評分與胚胎整倍率的相關性。結果發現，在整倍體胚胎移植中，當考慮到胚胎的KS5分數移植時，相較於基於形態學數據進行胚移植時，前者的著床率和繼續妊娠率（75.00％vs 50.00％；p = 0.002和66.66％ vs 48.83％；p = 0.037）都明顯更高，具有顯著差異。此外，KS5最高得分（KS5 = 6）與最低（KS5 = 1）的囊胚, 著床率為（80.00％vs 49.02％; p = 0.045）也具有顯著差異，但繼續妊娠率（72.00％ vs 47.06％; p = 0.105）未發現顯著性差異。同時，KS5 = 6的胚胎和KS5 = 1的胚胎，整倍體率分別（61.88％ vs 48.33％; p = 0.006），前者的整倍體率明顯更高，具有顯著差異。結論，使用KS5算法的評分選擇胚胎可提高單個整倍體囊胚移植的著床率。此外，KS5分數最高的胚胎更有可能有更高的整倍體率和著床率。