Time-lapse culture with morphokinetic embryo selection improves pregnancy and live birth chances and reduces early pregnancy loss: a meta-analysis

REPRODUCTIVE BIOMEDICINE ONLINE

卷:35

Review

Csaba, Pribenszky¹  Nilselid, Anna-Maria²  Montag, Markus³ 

[1] Univ Vet Sci, Istvan U 2, H-1078 Budapest, Hungary

[2] Vitrolife Sweden AB, Box 9080, SE-40092 Gothenburg, Sweden

[3] Ilabcomm GmbH, Eisenachstr 34, D-53757 St Augustin, Germany

关键词: Algorithm;    Embryo evaluation;    Embryo selection;    Morphokinetics;    Single embryo transfer;    Time-lapse imaging;   

DOI  :  10.1016/j.rbmo.2017.06.022

来源: Elsevier

【 摘 要 】

Embryo evaluation and selection is fundamental in clinical IVF. Time-lapse follow-up of embryo development comprises undisturbed culture and the application of the visual information to support embryo evaluation. A meta-analysis of randomized controlled trials was carried out to study whether time-lapse monitoring with the prospective use of a morphokinetic algorithm for selection of embryos improves overall clinical outcome (pregnancy, early pregnancy loss, stillbirth and live birth rate) compared with embryo selection based on single time-point morphology in IVF cycles. The meta-analysis of five randomized controlled trials (n = 1637) showed that the application of time-lapse monitoring was associated with a significantly higher ongoing clinical pregnancy rate (51.0% versus 39.9%), with a pooled odds ratio of 1.542 (P < 0.001), significantly lower early pregnancy loss (15.3% versus 21.3%; OR: 0.662; P = 0.019) and a significantly increased live birth rate (44.2% versus 31.3%; OR 1.668; P = 0.009). Difference in stillbirth was not significant between groups (4.7% versus 2.4%). Quality of the evidence was moderate to low owing to inconsistencies across the studies. Selective application and variability were also limitations. Although time-lapse is shown to significantly improve overall clinical outcome, further high-quality evidence is needed before universal conclusions can be drawn. (C) 2017 The Author(s). Published by Elsevier Ltd on behalf of Reproductive Healthcare Ltd.

【 授权许可】

Free