Abstract：
OBJECTIVE: To 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.
METHODS: We 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).
RESULTS: A 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.
CONCLUSIONS: Low- 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.
METHODS: We 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).
RESULTS: A 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.
CONCLUSIONS: Low- 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.
摘要：
目的：探讨延时监测（TLM）系统与常规形态学选择（CMS）相比，胚胎选择对体外受精/卵胞浆内单精子注射（IVF/ICSI）结局的影响。
方法：我们搜索了PubMed，Ovid-Embase,和Cochrane库用于以下研究：在比较1中，在基于形态学的TLM培养箱中使用TLM图像进行胚胎选择，而在基于形态学的常规培养箱中使用CMS进行胚胎选择；在比较2中，使用基于形态动力学的TLM进行胚胎选择，而使用基于形态学的CMS进行胚胎选择。主要结果是活产率（LBR），持续妊娠率（OPR），临床妊娠率（CPR），和植入率（IR），次要结局是流产率（MR）。
结果：共纳入14项随机对照试验。两者都基于形态学，TLM孵化器增加了IR（风险比[RR]：1.10；95％置信区间[CI]：1.01，1.18；I2=0％，中等质量的证据)与传统孵化器相比。低到中等质量的证据表明，TLM孵化器并没有改善LBR，OPR,CPR,和MR与传统孵化器相比。此外,低到中等质量的证据表明，使用基于形态动力学的TLM进行胚胎选择并不能改善LBR，OPR,CPR,IR,或MR与基于形态学的CMS相比。
结论：低到中等质量的证据表明，TLM孵化器和使用基于形态动力学的TLM的胚胎选择均未改善临床结局（LBR，OPR,CPR,和MR）与基于形态学的CMS进行比较。TLM仍然是IVF/ICSI实践的研究程序。
方法：我们搜索了PubMed，Ovid-Embase,和Cochrane库用于以下研究：在比较1中，在基于形态学的TLM培养箱中使用TLM图像进行胚胎选择，而在基于形态学的常规培养箱中使用CMS进行胚胎选择；在比较2中，使用基于形态动力学的TLM进行胚胎选择，而使用基于形态学的CMS进行胚胎选择。主要结果是活产率（LBR），持续妊娠率（OPR），临床妊娠率（CPR），和植入率（IR），次要结局是流产率（MR）。
结果：共纳入14项随机对照试验。两者都基于形态学，TLM孵化器增加了IR（风险比[RR]：1.10；95％置信区间[CI]：1.01，1.18；I2=0％，中等质量的证据)与传统孵化器相比。低到中等质量的证据表明，TLM孵化器并没有改善LBR，OPR,CPR,和MR与传统孵化器相比。此外,低到中等质量的证据表明，使用基于形态动力学的TLM进行胚胎选择并不能改善LBR，OPR,CPR,IR,或MR与基于形态学的CMS相比。
结论：低到中等质量的证据表明，TLM孵化器和使用基于形态动力学的TLM的胚胎选择均未改善临床结局（LBR，OPR,CPR,和MR）与基于形态学的CMS进行比较。TLM仍然是IVF/ICSI实践的研究程序。
