A randomized clinical trial comparing embryo culture in a conventional incubator with a time-lapse incubator
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Time-lapse monitoring allows for a flexible embryo evaluation and potentially provides new dynamic markers of embryo competence. Before introducing time-lapse monitoring in a clinical setting, the safety of the instrument must be properly documented. Accordingly, the aim of this study was to evaluate the safety of a commercially available time-lapse incubator.
In a two center, randomized, controlled, clinical trial 676 oocytes from 59 patients in their 2nd or third treatment cycle, age <38 years and ≥8 oocytes retrieved were cultured in the time-lapse incubator or in a conventional incubator. The primary outcome was proportion of 4-cell embryos on day 2. Secondary outcomes were proportion of 7–8 cell embryos on day 3 and proportion of blastocysts on day 5. Implantation pregnancy rates were registered based on presence of fetal heart activity visualized by ultrasound 8 weeks after embryo transfer.
No significant difference was found between the time-lapse incubator (TLI) and conventional incubator (COI) in proportion of 4-cell embryos on day 2 irrespective of whether data was analyzed according to ITT (RRTLI/COI: 0.81 (0.65; 1.02)) or PP (RRTLI/COI: 0.80 (0.63; 1.01)). Nor were any significant differences detected in the secondary endpoints; i.e. proportion of 7–8-cell embryos on day three ITT (RRTLI/COI: 0.96 (0.73; 1.26)); PP (RRTLI/COI: 0.95 (0.72; 1.26)) and proportion of blastocysts on day five ITT (RRTLI/COI: 1.09 (0.84; 1.41)); PP (RRTLI/COI: 1.09 (0.83: 1.41)). We found no differences in clinical pregnancy rate or implantation rate.
Culture in the time-lapse incubator supports embryonic development equally to a conventional incubator.
KeywordsTime-lapse monitoring Safety Embryo culture Human ART
The authors wish to thank the clinical, paramedical and laboratory team of the Fertility Clinic, Aarhus University Hospital, Skejby and the Fertility Clinic, Copenhagen University Hospital Rigshospitalet. Unisense FertiliTech is thanked for providing EmbryoSlides. Inge Agerholm is thanked for scientific discussions.
Unisense FertiliTech provided EmbryoSlides.
The authors have nothing to declare
- 4.Beraldi R, Sciamanna I, Mangiacasale R, Lorenzini R, Spadafora C. Mouse early embryos obtained by natural breeding or in vitro fertilization display a differential sensitivity to extremely low-frequency electromagnetic fields. Mutat Res. 2003;538(1–2):163–70. doi: S1383-03),/S1383-5718(03),00116-5.PubMedGoogle Scholar
- 5.Cruz M, Gadea B, Garrido N, Pedersen KS, Martinez M, Perez-Cano I, Munoz M, Meseguer M. Embryo quality, blastocyst and ongoing pregnancy rates in oocyte donation patients whose embryos were monitored by time-lapse imaging. J Assist Reprod Genet. 2011. doi: 10.1007/s10815-011-9549-1.
- 10.Hardarson T, Ahlström A, Rogberg L, Botros L, Hillensjö T, Westlander G, Sakkas D, Wikland M. Non-invasive metabolomic profiling of Day 2 and 5 embryo culture medium: a prospective randomized trial. Hum Rep. 2011. doi: 10.1093/humrep/der373.
- 11.Hardarson T, Hanson C, Lundin K, Hillensjo T, Nilsson L, Stevic J, Reismer E, Borg K, Wikland M, Bergh C. Preimplantation genetic screening in women of advanced maternal age caused a decrease in clinical pregnancy rate: a randomized controlled trial. Hum Rep. 2008;23(12):2806–12. doi: 10.1093/humrep/den217.CrossRefGoogle Scholar
- 16.The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Rep. 2011;doi: 10.1093/humrep/der037
- 22.Mastenbroek S, Twisk M, van Echten-Arends J, Sikkema-Raddatz B, Korevaar JC, Verhoeve HR, Vogel NE, Arts EG, de Vries JW, Bossuyt PM, Buys CH, Heineman MJ, Repping S, van der Veen F. In vitro fertilization with preimplantation genetic screening. N Engl J Med. 2007;357(1):9–17. doi: 10.1056/NEJMoa067744.PubMedCrossRefGoogle Scholar
- 23.Meseguer M, Herrero J, Tejera A, Hilligsøe KM, Ramsing NB, Remohi J. The use of morphokinetics as a predictor of embryo implantation. Hum Rep. 2011. doi: 10.1093/humrep/der256.
- 25.Montag M, Liebenthron J, Koster M. Which morphological scoring system is relevant in human embryo development? Placenta. 2011. doi: S1383-03),/j.placenta.2011.07.009.
- 31.Pickering SJ, Taylor A, Johnson MH, Braude PR. An analysis of multinucleated blastomere formation in human embryos. Hum Rep. 1995;10(7):1912–22.Google Scholar
- 32.Pribenszky C, Losonczi E, Molnar M, Lang Z, Matyas S, Rajczy K, Molnar K, Kovacs P, Nagy P, Conceicao J, Vajta G. Prediction of in-vitro developmental competence of early cleavage-stage mouse embryos with compact time-lapse equipment. Reprod Biomed Online. 2010;20(3):371–9. doi: S1383-03),/j.rbmo.2009.12.007.PubMedCrossRefGoogle Scholar
- 35.Scott L, Berntsen J, Davies D, Gundersen J, Hill J, Ramsing N. Symposium: innovative techniques in human embryo viability assessment. Human oocyte respiration-rate measurement–potential to improve oocyte and embryo selection? Reprod Biomed Online. 2008;17(4):461–9. doi: S1383-03),/S1472-6483(10)60232-5.PubMedCrossRefGoogle Scholar
- 38.Staessen C, Platteau P, Van Assche E, Michiels A, Tournaye H, Camus M, Devroey P, Liebaers I, Van Steirteghem A. Comparison of blastocyst transfer with or without preimplantation genetic diagnosis for aneuploidy screening in couples with advanced maternal age: a prospective randomized controlled trial. Hum Rep. 2004;19(12):2849–58. doi: 10.1093/humrep/deh536.CrossRefGoogle Scholar
- 39.Steer CV, Mills CL, Tan SL, Campbell S, Edwards RG. The cumulative embryo score: a predictive embryo scoring technique to select the optimal number of embryos to transfer in an in-vitro fertilization and embryo transfer programme. Hum Rep. 1992;7(1):117–9.Google Scholar