A randomized clinical trial comparing embryo culture in a conventional incubator with a time-lapse incubator

  • Kirstine KirkegaardEmail author
  • Johnny Juhl Hindkjaer
  • Marie Louise Grøndahl
  • Ulrik Schiøler Kesmodel
  • Hans Jakob Ingerslev
Technical Innovations



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.


Time-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.

Disclosure statement

The authors have nothing to declare


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Kirstine Kirkegaard
    • 1
    Email author
  • Johnny Juhl Hindkjaer
    • 1
  • Marie Louise Grøndahl
    • 2
  • Ulrik Schiøler Kesmodel
    • 1
  • Hans Jakob Ingerslev
    • 1
  1. 1.The Fertility Clinic, Aarhus University HospitalAarhus NDenmark
  2. 2.Fertility DepartmentCopenhagen University Hospital, RigshospitaletCopenhagen ØDenmark

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