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Want to know the hidden indicators of embryonic health? What do these molecular analyses reveal?
Embryo quality refers to the ability of an embryo to achieve a high pregnancy rate and/or produce a healthy individual. Embryo characterization is a method to evaluate embryo quality, providing guidance for embryo selection in in vitro fertilization (IVF) by qualitatively or quantitatively estimating various parameters. Typically, embryo analysis to predict pregnancy rates focuses on visual features and the expression of short-term biomarkers, including RNA and protein analyses, and these analyzes are best performed in the periphery of the embryo to avoid damage to the embryo. Embryo analysis for health prediction, meanwhile, is more genome-focused and often involves extracting cells from embryos for preimplantation genetic diagnosis when there is a risk of genetic disease.
Pregnancy rate prediction
Microscopic examination
Currently, assessment of embryo quality is mainly performed by microscopy at specific time points using a morphological scoring system. This method has been shown to significantly increase pregnancy rates. Assessment of morphological characteristics is a reliable, non-invasive method that provides valuable information for predicting IVF/Intracytoplasmic Sperm Injection (ICSI) outcome. Include the following points in your assessment parameters for Days 2-3:
The optimal cell number is 4 on day 2 and 8 on day 3. Cells dividing too quickly or too slowly may mean chromosomal abnormalities or embryonic arrest.
At the same time, the symmetry and size of the embryo also play an important role in quality assessment. If all cells are the same size, it is considered abnormal and may be highly associated with polyploidy.
Molecular analysis
Molecular analysis can be performed by extracting a single cell from the embryo. Analyzes can range from single target biomarkers to entire genomes, transcriptomes, proteomes, and metabolomes. The results can be used to score embryos based on patterns previously found in successful and failed pregnancies.
Transcriptome analysis
Research on gene expression analysis of human embryos is limited due to legal and ethical issues. Measuring gene expression in oocytes and granulosa cells surrounding early embryos offers an alternative that eliminates the need for invasive sampling from within the embryo. These analyzes can provide valuable information on the efficiency of ovarian hyperstimulation protocols and indirectly predict oocyte and embryonic development.
Proteome analysis
Embryo quality is assessed indirectly by taking samples of proteins surrounding the embryo. Typical protein markers for this non-invasive method include CXCL13 and granulocyte-macrophage colony-stimulating factor. Lower protein content is associated with higher engraftment rates.
Genomic analysis
A systematic review of a large number of randomized controlled trials found that genomic profiling (PGP) has no clear benefit in improving live birth rates. On the contrary, for older women, PGP even significantly reduces their live birth rate.
Health prediction
Currently, the main method used to predict the health of an individual resulting from an embryo is preimplantation genetic diagnosis, which is designed to determine whether the subsequent product will inherit a specific disease. Although this technology may be effective in some cases, while taking into account the health of newborn individuals, technical flaws and genomic mosaicism that may lead to a decrease in live birth rates must also be considered.
These analysis methods provide us with a more penetrating understanding. However, in practice, can we make full use of this wisdom to choose the optimal starting point for future life?
