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Between-laboratory reproducibility of time-lapse embryo selection using qualitative and quantitative parameters: a systematic review and meta-analysis

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Abstract

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.

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Author information

Authors and Affiliations

  1. Reproductive Medicine Center, Tianjin United Family Hospital, Tianjin, China

    Yanhe Liu

  2. School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia

    Yanhe Liu & Phillip Matson

  3. School of Human Sciences, The University of Western Australia, Crawley, Australia

    Yanhe Liu

  4. Systematic Review Solutions Ltd, Shanghai, China

    Fang Qi & Sai Zhao

  5. Fertility Associates, Auckland, New Zealand

    Dean E. Morbeck

  6. Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia

    Ben W. Mol

  7. Department of Obstetrics and Gynaecology, Qingdao United Family Hospital, Qingdao, China

    Masoud Afnan

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  1. Yanhe Liu
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  2. Fang Qi
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  3. Phillip Matson
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Correspondence to Yanhe Liu.

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Supplemental Table 1

Characteristics of included studies for quantitative assessment (external validation of the Meseguer model) (DOCX 14 kb).

Supplemental Table 2

Characteristics of included studies for qualitative assessment (DOCX 17 kb).

Supplemental File 1

(DOCX 33 kb).

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Liu, Y., Qi, F., Matson, P. et al. Between-laboratory reproducibility of time-lapse embryo selection using qualitative and quantitative parameters: a systematic review and meta-analysis. J Assist Reprod Genet 37, 1295–1302 (2020). https://doi.org/10.1007/s10815-020-01789-4

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  • DOI: https://doi.org/10.1007/s10815-020-01789-4

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