胚胎质量评估方法的研究进展

选择植入发育潜能更高的胚胎是辅助生殖技术(ART)中最主要的挑战之一。形态学评分法是目前运用最为广泛的胚胎质量评估方法，但是由于存在观察者的人为误差，导致该方法评价胚胎质量并不准确。近十年，代谢组学和蛋白质组学不断发展，结合傅立叶变换红外(FTIR)光谱、近红外光谱(NIR)、¹H-质子核磁共振(¹H-NMR)光谱、拉曼光谱技术等新技术的临床应用，可以精确检测胚胎培养液中的各种代谢产物，如丙酮酸、氨基酸、人类白细胞抗原(HLA)-G等。研究结果表明，妊娠组胚胎培养液代谢产物与未妊娠组不同。因此，无创性代谢组学及蛋白质组学对于胚胎质量的评估，或许可被运用于临床指导体外受精(IVF)方案的调整，选择最优质的移植胚胎。然而，形态学评分法、代谢组学和蛋白质组学均不能检测胚胎染色体异常，基因组学可弥补这一缺憾。通过胚胎移植前基因组检测和筛查，可以排除非整倍体性胚胎，从而提高ART助孕成功率。笔者拟就胚胎质量评估方法研究的最新进展进行阐述。

Research progress of methods on the assessment of embryonic quality

Selection of embryos with higher potentiality of development has been one of the major challenges in assisted reproductive technology (ART). Morphological scoring method is a general method to evaluate embryonic quality, but it′s not an accurate method due to the personal error. In the past decade, with the development of metabolomics and proteomics, metabolities in embryo culture media such as pyruvate, amino acids, human leukocyte antigen (HLA)-G can be precisely analyzed by newly developed technologies such as Fourier transformation infrared (FTIR) spectroscopy, near infrared spectroscopy (NIR), ¹H-proton nuclear magnetic resonance (¹H-NMR) spectroscopy, and Raman spectroscopy. Studies have shown that the metabolic profiles vary between pregnancy and non-pregnancy embryos. Thus, noninvasive metabolomics and proteomics might be applied to guide clinical protocol adjustments of in vitro fertilization (IVF) and select transplanted embryo with the best quality. However, chromosome abnormalities in embryo can not be detected by morphological scoring method, metabolomics, proteomics, and genomics can make up for this deficiency. Genomic screening could be conducted to detect non-euploidy embryo before transplantation and thus improve the success rate of ART. This paper reviews the latest research progress of the embryo quality assessment methods.