Noninvasive embryo evaluation and selection by time-lapse monitoring vs. conventional morphologic assessment in women undergoing in vitro fertilization/intracytoplasmic sperm injection: a single-center randomized controlled study

Meng, Qingyu; Xu, Ye; Zheng, Aiyan; Li, Hong; Ding, Jie; Yang, Xu; Peng, Yan; Wang, Wei; Wu, Huihua

doi:10.1016/j.fertnstert.2022.02.015

Cited by 17 publications

(12 citation statements)

References 34 publications

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“…LBR was reported in six studies. 22,24,30,32,39,40 The metaanalysis with a random effect model showed that embryo selection using TLM did not improve LBR compared with CMS (RR: 1.07; 95% CI: 0.91, 1.24; I 2 = 69%, low-quality evidence); see Figure 3a and Table S7.…”

Section: Results Of Meta-analysis In Comparisonmentioning

confidence: 99%

“…However, an important recently published randomized controlled trial (RCT) did not show any benefits of TLM in LBR 22 . In addition, other published RCTs provide new evidence for the practical value of the TLM system in embryo selection 23–25 . A timely summary of clinical evidence is necessary.…”

Section: Introductionmentioning

confidence: 99%

“…22 In addition, other published RCTs provide new evidence for the practical value of the TLM system in embryo selection. [23][24][25] A timely summary of clinical evidence is necessary. Therefore, the purpose of this systematic review and meta-analysis is to explore the effect of embryo selection using TLM compared with CMS on IVF/ICSI outcomes.…”

Section: Introductionmentioning

confidence: 99%

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The effect of embryo selection using time‐lapse monitoring on IVF/ICSI outcomes: A systematic review and meta‐analysis

Jiang,

Wang,

Wang

et al. 2023

J of Obstet and Gynaecol

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AimTo explore the effect of embryo selection using the time‐lapse monitoring (TLM) system compared with conventional morphological selection (CMS) on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes.MethodsWe searched PubMed, Ovid‐Embase, and The Cochrane Library for the following studies: At Comparison 1, embryo selection using TLM images in a TLM incubator based on morphology versus embryo selection using CMS in a conventional incubator based on morphology; at Comparison 2, embryo selection using TLM based on morphokinetics versus embryo selection using CMS based on morphology. The primary outcomes were the live birth rate (LBR), ongoing pregnancy rate (OPR), clinical pregnancy rate (CPR), and implantation rate (IR), and the secondary outcome was the miscarriage rate (MR).ResultsA total of 14 randomized control trials (RCTs) were included. Both based on morphology, TLM incubators increased the IR (risk ratio [RR]: 1.10; 95% confidence interval [CI]: 1.01, 1.18; I2 = 0%, moderate‐quality evidence) compared to conventional incubators. Low‐ to moderate‐quality evidence suggests that TLM incubators did not improve LBR, OPR, CPR, and MR compared to conventional incubators. In addition, low‐ to moderate‐quality evidence indicates that embryo selection using TLM based on morphokinetics did not improve LBR, OPR, CPR, IR, or MR compared to CMS based on morphology.ConclusionsLow‐ to moderate‐quality evidence suggests that neither TLM incubators nor embryo selection using TLM based on morphokinetics improved clinical outcomes (LBR, OPR, CPR, and MR) compared with CMS based on morphology. TLM is still an investigational procedure for IVF/ICSI practice.

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Section: Results Of Meta-analysis In Comparisonmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effect of embryo selection using time‐lapse monitoring on IVF/ICSI outcomes: A systematic review and meta‐analysis

Jiang,

Wang,

Wang

et al. 2023

J of Obstet and Gynaecol

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Section: Clinical Outcomes Of Tlms and Secm Analysis In Human Ivf-et ...mentioning

confidence: 88%

“…However, a couple of studies have reported that the evidence for significant advantages of TLMS remains unclear [110][111][112]. Elective single cleavage-stage embryo transfer with TLMS did not have any advantages over conventional observation in young women with good ovarian reserve [111]. That study also suggested that single blastocyst transfer with TLMS does not increase the likelihood of ongoing pregnancy compared to conventional observation; in particular, the use of a TLMS to choose blastocysts for fresh single embryo transfer on day 5 did not improve ongoing pregnancy rate compared to morphology alone [112].…”

Section: Clinical Outcomes Of Tlms and Secm Analysis In Human Ivf-et ...mentioning

confidence: 99%

Non-invasive evaluation of embryo quality for the selection of transferable embryos in human in vitro fertilization-embryo transfer

Kim

Lee

Jun

2022

Clin Exp Reprod Med

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The ultimate goal of human assisted reproductive technology is to achieve a healthy pregnancy and birth, ideally from the selection and transfer of a single competent embryo. Recently, techniques for efficiently evaluating the state and quality of preimplantation embryos using time-lapse imaging systems have been applied. Artificial intelligence programs based on deep learning technology and big data analysis of time-lapse monitoring system during in vitro culture of preimplantation embryos have also been rapidly developed. In addition, several molecular markers of the secretome have been successfully analyzed in spent embryo culture media, which could easily be obtained during in vitro embryo culture. It is also possible to analyze small amounts of cell-free nucleic acids, mitochondrial nucleic acids, miRNA, and long non-coding RNA derived from embryos using real-time polymerase chain reaction (PCR) or digital PCR, as well as next-generation sequencing. Various efforts are being made to use non-invasive evaluation of embryo quality (NiEEQ) to select the embryo with the best developmental competence. However, each NiEEQ method has some limitations that should be evaluated case by case. Therefore, an integrated analysis strategy fusing several NiEEQ methods should be urgently developed and confirmed by proper clinical trials.

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Developmental perturbation in human embryos: Clinical and biological significance learned from time‐lapse images

Ezoe,

Takahashi,

Miki

et al. 2024

Reprod Medicine & Biology

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BackgroundTime‐lapse technology (TLT) has gained widespread adoption worldwide. In addition to facilitating the undisturbed culture of embryos, TLT offers the unique capability of continuously monitoring embryos to detect spatiotemporal changes. Although these observed phenomena play a role in optimal embryo selection/deselection, the clinical advantages of introducing TLT remain unclear. However, manual annotation of embryo perturbation could facilitate a comprehensive assessment of developmental competence. This process requires a thorough understanding of embryo observation and the biological significance associated with developmental dogma and variation. This review elucidates the typical behavior and variation of each phenomenon, exploring their clinical significance and research perspectives.MethodsThe MEDLINE database was searched using PubMed for peer‐reviewed English‐language original articles concerning human embryo development.Main findingsTLT allows the observation of consecutive changes in embryo morphology, serving as potential biomarkers for embryo assessment. In assisted reproductive technology laboratories, several phenomena have not revealed their mechanism, posing difficulties such as fertilization deficiency and morula arrest.ConclusionA profound understanding of the biological mechanisms and significance of each phenomenon is crucial. Further collaborative efforts between the clinical and molecular fields following translational studies are required to advance embryonic outcomes and assessment.

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Noninvasive embryo evaluation and selection by time-lapse monitoring vs. conventional morphologic assessment in women undergoing in vitro fertilization/intracytoplasmic sperm injection: a single-center randomized controlled study

Cited by 17 publications

References 34 publications

The effect of embryo selection using time‐lapse monitoring on IVF/ICSI outcomes: A systematic review and meta‐analysis

The effect of embryo selection using time‐lapse monitoring on IVF/ICSI outcomes: A systematic review and meta‐analysis

Non-invasive evaluation of embryo quality for the selection of transferable embryos in human in vitro fertilization-embryo transfer

Developmental perturbation in human embryos: Clinical and biological significance learned from time‐lapse images

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