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Effect of embryo selection based morphokinetics on IVF/ICSI outcomes: evidence from a systematic review and meta-analysis of randomized controlled trials

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Abstract

Purpose

Debate exists for the optimal tool to select embryos for transfer in assisted reproductive technology (ART). Time-lapse monitoring (TLM) is a noninvasive tool suggested where each embryo can be captured every 5–20 min. Given the inconsistency in the existing studies, we conducted this meta-analysis of RCTs to summarize the evidence available concerning the predictive ability of morphokinetics compared with the routine assessment of embryo development in ART.

Methods

The primary databases MEDLINE, EMBASE, Cochrane, NHS, WHO, and Other Non-Indexed Citations were consulted for RCTs that have been published until November 2018, with no language restriction.

Results and conclusion

Our review includes 6 RCTs (n = 2057 patients). The data showed an improvement (~ 9%) in live birth TLM (OR 1.43; 95% CI 1.10–1.85; P = 0.007), with low-quality evidence. There was no evidence of a significant difference between both groups concerning ongoing pregnancy, clinical pregnancy and implantation rates. The data further showed that morphokinetics is associated with decreased early pregnancy loss rate. These estimates must be interpreted with caution owing to the statistical and clinical heterogeneities and the consequent difficulty in drawing any meaningful conclusion.

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Author information

Authors and Affiliations

  1. Al-Yasmeen Fertility and Gynecology Center, 5 Farid Nada Street, Benha, 13511, Qalubyia, Egypt

    Yasmin Magdi

  2. Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt

    Ahmed Samy

  3. Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt

    Ahmed M. Abbas

  4. Department of Obstetrics and Gynecology, Faculty of Medicine, Benha University, Benha, Egypt

    Mohamed Ahmed Ibrahim, Yehia Edris & Ayman El-Gohary

  5. Department of Obstetrics and Gynecology, Faculty of Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt

    Ahmed M. Fathi

  6. IbnSina IVF Center, IbnSina Hospital, Sohag, Egypt

    Mohamed Fawzy

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  1. Yasmin Magdi
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  2. Ahmed Samy
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  3. Ahmed M. Abbas
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  4. Mohamed Ahmed Ibrahim
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  7. Ahmed M. Fathi
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Contributions

Y.M.: study conception and design, data extraction and managing, drafting and revision of the article; A.S.: study conception, data extraction and managing; A.M.A.: revision and final approval of the article; M.A.I.: revision and final approval of the article; Y.E.: data interpretation, critical revision and final approval of the article; A.E.: critical revision and final approval of the article; A.M.F.: revision and final approval of the article; M.F.: involved in study design, drafting and revision of the article.

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Correspondence to Yasmin Magdi.

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Magdi, Y., Samy, A., Abbas, A.M. et al. Effect of embryo selection based morphokinetics on IVF/ICSI outcomes: evidence from a systematic review and meta-analysis of randomized controlled trials. Arch Gynecol Obstet 300, 1479–1490 (2019). https://doi.org/10.1007/s00404-019-05335-1

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  • DOI: https://doi.org/10.1007/s00404-019-05335-1

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