基于胚胎时差成像技术的胚胎动力学参数对体外受精-胚胎移植助孕患者胚胎着床潜力的预测价值

doi:10.3969/j.issn.1006-5725.2026.08.020

Abstract

Abstract:

Objective To evaluate the predictive value of embryo dynamics parameters during embryo time-lapse imaging technique on embryo implantation potential in patients receiving in vitro fertilization-embryo transfer （IVF-ET） assisted pregnancy. Methods A total of 292 patients who underwent IVF-ET assisted pregnancy at Nanyang First People's Hospital between June 2022 and June 2024 were selected as study subjects. After 28 days of transplantation， the patients were divided into 103 cases in implantation group and 189 cases in non-implantation group based on the embryo implantation status detected by B-ultrasound. The basic data and embryo dynamics parameters of the patients in each group were compared. Multivariate logistic regression analysis was conducted to identify high-risk factors for embryo non-implantation in patients with IVF-ET assisted pregnancy. Subsequently， the predictive value of these high-risk factors on embryo implantation potential was evaluated by using receiver operating characteristic （ROC） curve. Results Compared with implantation group， the embryo dynamics parameters in non-implantation group were higher， including the time of pronuclear breakdown to 2-cell stage （t2）， time of pronuclear breakdown to 3-cell stage （t3）， time of pronuclear breakdown to 4-cell stage （t4）， time of 2-cell division to 3-cell stage （cc2）， time of 3-cell division to 4-cell stage （s2）， and time of 4-cell division to 5-cell stage （cc3）（P < 0.05）. t2 （OR = 4.293）， t3 （OR = 0.507）， t4 （OR = 5.534） and s2 （OR = 3.755） were independent risk factors for embryo non-implantation in patients with IVF-ET assisted pregnancy （P < 0.05）. t2， t3， t4 and s2 had high predictive efficiency on embryo implantation failure in patients with IVF-ET assisted pregnancy， and their areas under the curves （AUCs） were 0.767， 0.744， 0.720 and 0.878 respectively （P < 0.05）， and the efficiency of s2 in predicting embryo non-implantation in patients with IVF-ET assisted pregnancy was higher than that of t2， t3 or t4 （Z = 3.044， 3.563， 4.413， P < 0.05）. Conclusions The levels of embryo dynamics parameters t2， t3， t4 and s2 are closely related to the embryo implantation in patients with IVF-ET assisted pregnancy. The use of embryo time-lapse imaging technique can assist medical staff in predicting the embryo implantation potential in patients with IVF-ET assisted pregnancy.

Key words: embryo time-lapse imaging technique, embryo dynamics, in vitro fertilization-embryo transfer, embryo implantation

CLC Number:

R711

Xiaoxin HU,Yanchen GUO,Xiaolin LIU,Ying WANG,Hong YAN. Predictive value of embryo dynamics parameters based on embryo time-lapse imaging technique on embryo implantation potential in patients with IVF-ET assisted pregnancy[J]. The Journal of Practical Medicine, 2026, 42(8): 1450-1455.

Figures/Tables 6

Tab.1

Comparison of general data between the two groups of patients with IVF-ET assisted pregnancy"

指标	例数	着床组（n = 103）	未着床组（n = 189）	χ²/t值	P值
年龄				0.763	0.383
23 ~3 0岁	183	68（66.02）	115（60.85）
> 30岁	109	35（33.98）	74（39.15）
不孕年限（ $x ˉ ? ± ? s$ ）/年	-	3.96 ± 1.20	4.14 ± 1.06	1.323	0.187
FSH（ $x ˉ ? ± ? s$ ）/（IU/L）	-	5.47 ± 1.40	5.61 ± 1.03	0.974	0.331
E₂（ $x ˉ ? ± ? s$ ）/（pmol/L）	-	144.09 ± 38.35	137.76 ± 43.14	1.245	0.214
LH（ $x ˉ ? ± ? s$ ）/（IU/L）	-	6.81 ± 2.11	6.59 ± 2.06	0.865	0.388
P（ $x ˉ ? ± ? s$ ）/（ng/mL）		1.14 ± 0.25	1.19 ± 0.23	1.721	0.086
体质量指数				3.904	0.142
< 18.5 kg/m²	38	15（14.56）	23（12.17）
18.5 ~ 24.9 kg/m²	206	77（74.76）	129（68.25）
> 24.9 kg/m²	48	11（10.63）	37（19.58）
Gn用量（ $x ˉ ? ± ? s$ ）/IU	-	2 148.36 ± 183.75	2 175.96 ± 207.69	1.129	0.260
Gn天数（ $x ˉ ? ± ? s$ ）/d	-	8.94 ± 1.37	9.17 ± 1.80	1.130	0.259
男方年龄				1.352	0.245
23 ~ 30岁	172	56（54.37）	116（61.38）
> 30岁	120	47（45.63）	73（38.62）
前向运动精子数（ $x ˉ$ $? ± ? s$ ）/（×10⁶/mL）	-	76.12 ± 23.36	71.94 ± 17.57	1.724	0.086
子宫内膜厚度（ $x ˉ ? ± ? s$ ）/mm	-	9.86 ± 2.37	10.07 ± 2.11	0.778	0.437
获卵数（ $x ˉ ? ± ? s$ ）/个	-	14.35 ± 2.01	13.85 ± 2.44	1.777	0.077
正常受精数（ $x ˉ ? ± ? s$ ）/个	-	7.92 ± 1.91	7.60 ± 1.85	1.396	0.164
卵裂胚胎数（ $x ˉ ? ± ? s$ ）/个	-	7.36 ± 2.47	6.89 ± 2.14	1.697	0.091

Tab.1

Tab.2

Tab.3

Tab.4

Tab.5

Fig.1

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指标	着床组（n = 103）	未着床组（n = 189）	t值	P值
t2	25.96 ± 2.84	27.84 ± 3.12	5.075	< 0.001
t3	38.29 ± 3.17	40.06 ± 2.35	5.418	< 0.001
t4	40.14 ± 6.51	43.73 ± 5.62	4.928	< 0.001
t5	52.36 ± 5.32	53.08 ± 6.19	0.997	0.320
t6	55.75 ± 2.44	56.17 ± 2.13	1.528	0.128
t7	57.07 ± 2.37	57.46 ± 2.78	1.205	0.229
t8	58.85 ± 2.29	59.17 ± 2.40	1.106	0.270
cc2	9.62 ± 2.54	11.77 ± 2.42	7.128	< 0.001
s2	0.81 ± 0.22	2.19 ± 0.60	22.517	< 0.001
cc3	13.75 ± 2.36	14.07 ± 1.79	1.301	0.194
s3	5.72 ± 1.61	8.50 ± 1.74	13.388	< 0.001

变量	赋值
胚胎着床情况	着床=0，未着床=1
t2	低水平=0，高水平=1
t3	低水平=0，高水平=1
t4	低水平=0，高水平=1
cc2	低水平=0，高水平=1
s2	低水平=0，高水平=1
s3	低水平=0，高水平=1

指标	β	SE	Waldχ²	P值	OR	95%CI
t2	1.457	0.392	13.815	< 0.001	4.293	1.991～9.256
t3	1.706	0.584	8.534	0.004	5.507	1.753～17.299
t4	1.711	0.496	11.900	< 0.001	5.534	2.094～14.631
cc2	1.670	0.852	3.842	0.051	3.842	1.000～28.217
s2	1.323	0.421	9.875	0.002	3.755	1.645～8.569
s3	1.541	0.879	3.073	0.080	4.669	0.834～26.150

指标	cut-off	AUC	95%CI	约登指数	敏感度/%	特异度/%	P值
t2	27.02 h	0.767	0.715 ～ 0.815	0.572	81.48	75.73	< 0.001
t3	39.76 h	0.744	0.690 ～ 0.793	0.471	76.19	70.87	< 0.001
t4	41.95 h	0.720	0.665 ～ 0.771	0.442	76.19	67.96	< 0.001
s2	1.44 h	0.878	0.878 ～ 0.913	0.590	85.19	73.79	< 0.001

Predictive value of embryo dynamics parameters based on embryo time-lapse imaging technique on embryo implantation potential in patients with IVF-ET assisted pregnancy

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