1
|
Mei Y, Lin Y, Chen Y, Zheng J, Ke X, Liang X, Wang F. Preimplantation genetic testing for aneuploidy optimizes reproductive outcomes in recurrent reproductive failure: a systematic review. Front Med (Lausanne) 2024; 11:1233962. [PMID: 38384413 PMCID: PMC10879326 DOI: 10.3389/fmed.2024.1233962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 01/26/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction Recurrent reproductive failure (RRF) is a common pregnancy complication, imposing great physical, emotional and financial burden for the suffered couples. The leading cause of RRF is believed to be aneuploid embryo, which could be solved by preimplantation genetic testing for aneuploidy (PGT-A) in theory. With molecular genetic development, PGT-A based on comprehensive chromosomal screening (CCS) procedures and blastocyst biopsy is widely applied in clinical practice. However, its effects in RRF were not defined yet. Methods A systematic bibliographical search was conducted without temporal limits up to June, 2023. Studies about the effects of PGT-A based on CCS procedures and blastocyst biopsy in RRF were included. Results Twenty studies about the effects of PGT-A based on CCS procedures and blastocyst biopsy in RRF were included. It revealed that PGT-A could optimise the reproductive outcomes of RRF sufferers, especially in those with advanced age. However, in patients with multiple occurrences of pregnancy losses, the benefits of PGT-A were limited. Discussion More randomized controlled trials with large sample size are required to evaluate the benefits of PGT-A in RRF sufferers and identify which population would benefit the most.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Fang Wang
- Department of Reproduction and Infertility, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
2
|
Danardono GB, Handayani N, Louis CM, Polim AA, Sirait B, Periastiningrum G, Afadlal S, Boediono A, Sini I. Embryo ploidy status classification through computer-assisted morphology assessment. AJOG Glob Rep 2023; 3:100209. [PMID: 37645653 PMCID: PMC10461251 DOI: 10.1016/j.xagr.2023.100209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Preimplantation genetic testing for aneuploidy has been proven to be effective in determining the embryo's chromosomal or ploidy status. The test requires a biopsy of embryonic cells on day 3, 5, or 6 from which complete information on the chromosomes would be obtained. The main drawbacks of preimplantation genetic testing for aneuploidy include its relatively invasive approach and the lack of research studies on the long-term effects of preimplantation genetic testing for aneuploidy. OBJECTIVE Computer-assisted predictive modeling through machine learning and deep learning algorithms has been proposed to minimize the use of invasive preimplantation genetic testing for aneuploidy. The capability to predict morphologic characteristics of embryo ploidy status creates a meaningful support system for decision-making before further treatment. STUDY DESIGN Image processing is a component in developing a predictive model specialized in image classification through which a model is able to differentiate images based on unique features. Image processing is obtained through image augmentation to capture segmented embryos and perform feature extraction. Furthermore, multiple machine learning and deep learning algorithms were used to create prediction-based modeling, and all of the prediction models undergo similar model performance assessments to determine the best model prediction algorithm. RESULTS An efficient artificial intelligence model that can predict embryo ploidy status was developed using image processing through a histogram of oriented gradient and then followed by principal component analysis. The gradient boosting algorithm showed an advantage against other algorithms and yielded an accuracy of 0.74, an aneuploid precision of 0.83, and an aneuploid predictive value (recall) of 0.84. CONCLUSION This research study proved that machine-assisted technology perceives the embryo differently than human observation and determined that further research on in vitro fertilization is needed. The study finding serves as a basis for developing a better computer-assisted prediction model.
Collapse
Affiliation(s)
- Gunawan Bondan Danardono
- IRSI Research and Training Centre, Jakarta, Indonesia (Mr Danardono, Ms Handayani, Mr Louis, Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
| | - Nining Handayani
- IRSI Research and Training Centre, Jakarta, Indonesia (Mr Danardono, Ms Handayani, Mr Louis, Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
| | - Claudio Michael Louis
- IRSI Research and Training Centre, Jakarta, Indonesia (Mr Danardono, Ms Handayani, Mr Louis, Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
| | - Arie Adrianus Polim
- IRSI Research and Training Centre, Jakarta, Indonesia (Mr Danardono, Ms Handayani, Mr Louis, Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
- Morula IVF Jakarta Clinic, Jakarta, Indonesia (Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
- Department of Obstetrics and Gynecology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia (Dr Polim)
| | - Batara Sirait
- IRSI Research and Training Centre, Jakarta, Indonesia (Mr Danardono, Ms Handayani, Mr Louis, Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
- Morula IVF Jakarta Clinic, Jakarta, Indonesia (Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
- Faculty of Medicine, Department of Obstetrics and Gynaecology, Universitas Kristen Indonesia, Jakarta, Indonesia (Dr Sirait)
| | - Gusti Periastiningrum
- IRSI Research and Training Centre, Jakarta, Indonesia (Mr Danardono, Ms Handayani, Mr Louis, Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
- Morula IVF Jakarta Clinic, Jakarta, Indonesia (Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
| | - Szeifoul Afadlal
- IRSI Research and Training Centre, Jakarta, Indonesia (Mr Danardono, Ms Handayani, Mr Louis, Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
- Morula IVF Jakarta Clinic, Jakarta, Indonesia (Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
| | - Arief Boediono
- IRSI Research and Training Centre, Jakarta, Indonesia (Mr Danardono, Ms Handayani, Mr Louis, Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
- Morula IVF Jakarta Clinic, Jakarta, Indonesia (Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
- Department of Anatomy, Physiology, and Pharmacology, Bogor Agricultural Institute University, Bogor, Indonesia (Dr Boediono)
| | - Ivan Sini
- IRSI Research and Training Centre, Jakarta, Indonesia (Mr Danardono, Ms Handayani, Mr Louis, Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
- Morula IVF Jakarta Clinic, Jakarta, Indonesia (Drs Polim and Sirait, Ms Periastiningrum, and Mr Afadlal, Drs Boediono, and Sini)
| |
Collapse
|
3
|
Shi WH, Jiang ZR, Zhou ZY, Ye MJ, Qin NX, Huang HF, Chen SC, Xu CM. Different Strategies of Preimplantation Genetic Testing for Aneuploidies in Women of Advanced Maternal Age: A Systematic Review and Meta-Analysis. J Clin Med 2021; 10:jcm10173895. [PMID: 34501345 PMCID: PMC8432243 DOI: 10.3390/jcm10173895] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/12/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Preimplantation genetic testing for aneuploidies (PGT-A) is widely used in women of advanced maternal age (AMA). However, the effectiveness remains controversial. Method: We conducted a comprehensive literature review comparing outcomes of IVF with or without PGT-A in women of AMA in PubMed, Embase, and the Cochrane Central Register of Controlled Trials in January 2021. All included trials met the criteria that constituted a randomized controlled trial for PGT-A involving women of AMA (≥35 years). Reviews, conference abstracts, and observational studies were excluded. The primary outcome was the live birth rate in included random control trials (RCTs). Results: Nine randomized controlled trials met our inclusion criteria. For techniques of genetic analysis, three trials (270 events) performed with comprehensive chromosomal screening showed that the live birth rate was significantly higher in the women randomized to IVF/ICSI with PGT-A (RR = 1.30, 95% CI 1.03–1.65), which was not observed in six trials used with FISH as well as all nine trials. For different stages of embryo biopsy, only the subgroup of blastocyst biopsy showed a higher live birth rate in women with PGT-A (RR = 1.36, 95% CI 1.04–1.79). Conclusion: The application of comprehensive chromosome screening showed a beneficial effect of PGT-A in women of AMA compared with FISH. Moreover, blastocyst biopsy seemed to be associated with a better outcome than polar body biopsy and cleavage-stage biopsy.
Collapse
Affiliation(s)
- Wei-Hui Shi
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai 200030, China; (W.-H.S.); (Z.-Y.Z.); (M.-J.Y.); (H.-F.H.)
- Shanghai Key Laboratory of Embryo Original Diseases, 145 Guangyuan Road, Shanghai 200030, China
| | - Zi-Ru Jiang
- Obstetrics and Gynecology Hospital, Fudan University, 566 Fangxie Road, Shanghai 200011, China;
| | - Zhi-Yang Zhou
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai 200030, China; (W.-H.S.); (Z.-Y.Z.); (M.-J.Y.); (H.-F.H.)
- Shanghai Key Laboratory of Embryo Original Diseases, 145 Guangyuan Road, Shanghai 200030, China
| | - Mu-Jin Ye
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai 200030, China; (W.-H.S.); (Z.-Y.Z.); (M.-J.Y.); (H.-F.H.)
- Shanghai Key Laboratory of Embryo Original Diseases, 145 Guangyuan Road, Shanghai 200030, China
| | - Ning-Xin Qin
- Department of Assisted Reproductive Medicine, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai 200030, China;
| | - He-Feng Huang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai 200030, China; (W.-H.S.); (Z.-Y.Z.); (M.-J.Y.); (H.-F.H.)
- Shanghai Key Laboratory of Embryo Original Diseases, 145 Guangyuan Road, Shanghai 200030, China
- Obstetrics and Gynecology Hospital, Fudan University, 566 Fangxie Road, Shanghai 200011, China;
| | - Song-Chang Chen
- Shanghai Key Laboratory of Embryo Original Diseases, 145 Guangyuan Road, Shanghai 200030, China
- Obstetrics and Gynecology Hospital, Fudan University, 566 Fangxie Road, Shanghai 200011, China;
- Correspondence: (S.-C.C.); (C.-M.X.); Tel.: +86-21-33189900 (S.-C.C.); +86-21-64073897 (C.-M.X.)
| | - Chen-Ming Xu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai 200030, China; (W.-H.S.); (Z.-Y.Z.); (M.-J.Y.); (H.-F.H.)
- Shanghai Key Laboratory of Embryo Original Diseases, 145 Guangyuan Road, Shanghai 200030, China
- Obstetrics and Gynecology Hospital, Fudan University, 566 Fangxie Road, Shanghai 200011, China;
- Correspondence: (S.-C.C.); (C.-M.X.); Tel.: +86-21-33189900 (S.-C.C.); +86-21-64073897 (C.-M.X.)
| |
Collapse
|