title: External validation of a time-lapse prediction model.
abstract: OBJECTIVE
  To study the performance of a previously published implantation prediction model based on morphokinetics in a different setting, in an unselected population and with various embryo transfer strategies.
  
  
  METHODS
  Retrospective monocentric study.
  
  
  METHODS
  University-based assisted reproduction technology (ART) center.
  
  
  METHODS
  450 unselected couples undergoing intracytoplasmic sperm injection (ICSI) cycle with embryo culture in the EmbryoScope (Unisense Fertilitech), corresponding to 528 embryos with known implantation.
  
  
  METHODS
  None.
  
  
  METHODS
  Implantation rates (IR) in embryo categories defined by the model in the overall population and in subgroups according to the day of embryo transfer.
  
  
  RESULTS
  The distribution of IR among detailed morphokinetic categories in the overall population and in subgroups according to the day of embryo transfer was more heterogeneous than expected according to the published model. The distribution corresponded better to the original when a simplified version of the model was used, although it worked better in the cleavage-stage group than in the blastocyst-stage group.
  
  
  CONCLUSIONS
  This study was unsuccessful in replicating the sensitivity of the previously published model for predicting implantation rate of embryos ranked according to morphokinetic categories. Further work is required to assess the utility of the model for embryo selection. Each team using time-lapse technology should build a center-specific prediction model based on its own data and transfer policy.
authors.affiliation: Service de Médecine et Biologie du Développement et de la Reproduction, CHU de Nantes, Nantes, France; INSERM UMR1064, Nantes, France. Electronic address: thomas.freour@chu-nantes.fr.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fréour
authors.affiliation: Service de Médecine et Biologie du Développement et de la Reproduction, CHU de Nantes, Nantes, France; Centre d'AMP Procréalis, La Roche-sur-Yon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Le Fleuter
authors.affiliation: Service de Médecine et Biologie du Développement et de la Reproduction, CHU de Nantes, Nantes, France; INSERM UMR1064, Nantes, France.
authors.forename: Jenna
authors.initials: J
authors.lastname: Lammers
authors.affiliation: Service de Médecine et Biologie du Développement et de la Reproduction, CHU de Nantes, Nantes, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Splingart
authors.affiliation: Service de Médecine et Biologie du Développement et de la Reproduction, CHU de Nantes, Nantes, France; INSERM UMR1064, Nantes, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Reignier
authors.affiliation: Service de Médecine et Biologie du Développement et de la Reproduction, CHU de Nantes, Nantes, France; INSERM UMR1064, Nantes, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Barrière
mesh_terms: D000328:Adult; D001755:Blastocyst / Q000166:cytology; D046149:Embryo Culture Techniques; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007246:Infertility / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D015233:Models, Statistical; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000706:statistics & numerical data; D059008:Time-Lapse Imaging / Q000379:methods*
keywords: External validation; implantation; prediction model; time-lapse