PURPOSE To investigate the between-laboratory reproducibility of embryo selection/deselection effectiveness using qualitative and quantitative time-lapse parameters. METHODS A systematic search was performed on MEDLINE, EMBASE, and the Cochrane Library (up to February 2020) without restriction on date, language, document type, and publication status. Measuring outcomes included implantation, blastulation, good-quality blastocyst formation, and euploid blastocyst. RESULTS We detected 6 retrospective cohort studies externally validating the first clinical time-lapse model (Meseguer) emphasizing quantitative parameters, of which 3 (including one involving 2 independent centers) were included for the pooled analysis. Receiver operating characteristics analysis showed reduced predictive power of the model when either including or not including sister clinic validation. Fifteen cohort studies evaluating qualitative parameters were included for meta-analysis, and the mean Newcastle-Ottawa Scale was 5.3. Overall, meta-analysis showed significantly adverse association between the presence of ≥ 1 cleavage abnormalities and embryo implantation rates (11 studies, n = 7266; RR = 0.39[0.28, 0.55]95% CI; I2 = 57%). Further analysis showed adverse impacts of direct cleavage (7 studies, n = 7065; RR = 0.28 [0.15, 0.54] 95% CI; I2 = 46%), reverse cleavage (2 studies, n = 3622; RR = 0.16 [0.03, 0.75] 95% CI; I2 = 0%), chaotic cleavage (2 studies, n = 3643; RR = 0.11 [0.02, 0.69] 95% CI; I2 = 24%), and multinucleation (5 studies, n = 2576; RR = 0.59 [0.50, 0.69] 95% CI; I2 = 0%), but not the < 6 intercellular contact points at the 4-cell stage (1 study, n = 185; RR = 0.17 [0.02, 1.15] 95% CI). CONCLUSIONS Qualitative time-lapse parameters are reliably associated with embryo developmental potential among laboratories, whereas the reproducibility of time-lapse embryo selection model that emphasizes quantitative parameters may be compromised when externally applied.

中文翻译：

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使用定性和定量参数进行延时胚胎选择的实验室间再现性：系统评价和荟萃分析。

目的 使用定性和定量延时参数研究胚胎选择/取消选择有效性的实验室间可重复性。方法 在 MEDLINE、EMBASE 和 Cochrane 图书馆（截至 2020 年 2 月）上进行系统检索，不限制日期、语言、文献类型和出版状态。测量结果包括植入、囊胚形成、优质囊胚形成和整倍体囊胚。结果 我们发现 6 项回顾性队列研究在外部验证了第一个强调定量参数的临床延时模型 (Meseguer)，其中 3 项（包括一项涉及 2 个独立中心）被纳入汇总分析。接受者操作特征分析显示，无论是否包含姊妹诊所验证，模型的预测能力都会降低。荟萃分析纳入了 15 项评估定性参数的队列研究，纽卡斯尔-渥太华量表的平均值为 5.3。总体而言，荟萃分析显示，≥ 1 个卵裂异常的存在与胚胎着床率之间存在显着的负相关（11 项研究，n = 7266；RR = 0.39[0.28, 0.55]95% CI；I2 = 57%）。进一步分析显示直接裂解（7 项研究，n = 7065；RR = 0.28 [0.15, 0.54] 95% CI；I2 = 46%）、反向裂解（2 项研究，n = 3622；RR = 0.16 [0.03， 0.75] 95% CI；I2 = 0%）、混沌裂解（2 项研究，n = 3643；RR = 0.11 [0.02, 0.69] 95% CI；I2 = 24%）和多核化（5 项研究，n = 2576；RR = 0.11 [0.02, 0.69] 95% CI；I2 = 24%）。 RR = 0.59 [0.50, 0.69] 95% CI；I2 = 0%），但不是 4 细胞阶段 < 6 个细胞间接触点（1 项研究，n = 185；RR = 0.17 [0.02, 1.15] 95% CI）。结论 定性延时参数与实验室中的胚胎发育潜力可靠相关，而强调定量参数的延时胚胎选择模型的再现性在外部应用时可能会受到影响。