Abstract：Objective: To establish a prediction model for euploidy based on embryo morphokinetic parameters, so as to provide a reference for evaluating embryonic developmental potential in assisted reproductive technology.Methods: A retrospective analysis was performed on the clinical data of patients who underwent pre-implantation genetic testing between December 2020 and June 2023. A total of 1383 available blastocysts from 364 cycles were included. According to euploidy, the blastocysts were divided into the euploidy group (442 blastocysts) and the non-euploidy group (941 blastocysts). The morphokinetic parameters of the two groups were compared, and multivariate logistic regression analysis was performed. A prediction model for euploidy was constructed. The ROC curve was used to analyze the sensitivity and specificity of the prediction model. Meanwhile, morphokinetic parameters of 658 available blastocysts from 215 cycles included from July 2023 to April 2024 were used for clinical validation. The consistency between the prediction model and clinical practice was analyzed.Results: t4, t5, s2, time of starting blastulation (tSB), time of hatching blastocyst (tHB), and tHB-tSB in the euploidy group were shorter than those in the non-euploidy group (P<0.05). Logistic regression analysis found that t4, t5, s2, tSB, tHB, and tHB-tSB were influencing factors of blastocyst euploidy (P<0.05). A prediction model for euploidy was constructed as follows:P==ex/(1+ex), X=-3.299-0.026×t4-0.018×t5-0.264×s2-0.009×tSB-0.007×tHB-0.153×tHB-tSB. Hosmer-Lemeshow goodness of fit test showed that the prediction model had good goodness of fit (χ2=8.700, P=0.368). The area under the ROC curve of the prediction model was 0.871 (95%CI=0.852~0.889, P<0.001). Its sensitivity and specificity were 75.86% and 82.11%. Clinical validation indicated that the accuracy of the prediction model was 79.94%. The consistency between the prediction model and clinical practice was moderate (Kappa=0.561).Conclusion: Embryo morphokinetic parameters (t4, t5, s2, tSB, tHB and tHB-tSB) are related to the formation of euploidy. The prediction model constructed based on embryo morphokinetic parameters in this study is of high value in predicting embryo euploidy and can provide a reference for evaluating embryonic developmental potential.
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2024, Vol. 30 
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