Improved implantation rates of day 3 embryo transfers with the use of an automated time-lapse–enabled test to aid in embryo selection

Adamson, G. David; Abusief, Mary E.; Palao, L.; J, Witmer; Palao, Lonyl M.; Gvakharia, M.

doi:10.1016/j.fertnstert.2015.10.030

Cited by 85 publications

(43 citation statements)

References 25 publications

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“…TLM enables nearly continuous monitoring of embryo development through frequent multiple image acquisitions without potentially compromising viability due to the interruption of culture conditions (Wong et al, 2013). TLM algorithms have been successfully used to predict blastocyst formation (Wong et al, 2010), embryo aneuploidy (Chavez et al, 2012) (Campbell et al, 2013), and embryo implantation ) (Adamson et al, 2016. TLM algorithms have been successfully used to predict blastocyst formation (Wong et al, 2010), embryo aneuploidy (Chavez et al, 2012) (Campbell et al, 2013), and embryo implantation ) (Adamson et al, 2016.…”

Section: Introductionmentioning

confidence: 99%

High sperm DNA fragmentation delays human embryo kinetics when oocytes from young and healthy donors are microinjected

Esbert

Pacheco

Soares³

et al. 2018

Andrology

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Background: Time-lapse monitoring (TLM) technology has been implemented in the clinical setting for the culture and selection of human embryos. Many studies have assessed the association between sperm DNA fragmentation (sDNAf) and clinical outcomes after ART, but little is known about the influence of sDNA on embryo morphokinetics. Objectives: The objective of this retrospective study, which includes 971 embryos from 135 consecutive ICSI cycles (56 cases with own oocytes, 79 with oocytes from young and healthy donors), was to assess if sDNAf has an impact on embryo morphokinetics. Materials and methods: Samples used to perform ICSI were analyzed by the flow cytometry TUNEL assay, and embryo development was assessed through an EmbyoScope â system. The association between sDNAf and the timings of cell cleavage was analyzed by categorizing the first variable into quartiles: ≤6.50%; 6.51-10.70%; 10.71-20.15%; >20.15%. Results: In cases where sDNAf was above 20.15% (the upper quartile), embryos derived from donated oocytes (n = 644) showed significantly slower divisions. Such association was not observed in embryos obtained from the patients' own oocytes (n = 327). The embryo cleavage pattern (either normal, direct from 1 to 3 blastomeres, direct from 1 to 4 blastomeres, incomplete, reversed or asynchronous) was independent of the sDNAf level. Blastocyst arrival rate was 63.0% and the rate of good quality embryos (transferred and frozen embryos divided by the number of zygotes) was 45.49%. Neither parameter was related to the levels of sDNAf. Discussion: According to our results, the association between high sDNAf and donated oocytes led to delayed cell division. To our knowledge, this is the first study suggesting that sDNAf can delay human embryo cleavage timings when oocytes from donors are inseminated.Conclusions: This finding may indicate that, in the presence of increased DNA damage, time is needed before the first embryonic cell division for the activation of the optimal DNA repairing machinery in higher quality oocytes.

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Section: Introductionmentioning

confidence: 99%

High sperm DNA fragmentation delays human embryo kinetics when oocytes from young and healthy donors are microinjected

Esbert

Pacheco

Soares³

et al. 2018

Andrology

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“…After reading titles and abstracts, 2578 records clearly did not meet the eligible criteria, and 17 records were selected to undergo further full-text review. Among these studies, five were excluded because they were not randomized[12, 31–34]; one used a self-equipped TLI system and we excluded this study because the culture condition in the self-equipped system was hardly as stable as in a commercial instrument[35]. At the end, ten studies (eleven records) assessing the efficiency of TLI versus conventional methods in women undergoing IVF met our inclusion criteria and were included in our analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Based on the results of this review, no negative effect of EmbryoScope compared with conventional incubator is confirmed. Safety of Primo Vision and Eeva have been confirmed by some observational studies published in recent years[31–33, 43]. As to the efficiency, economical burden and embryo assessment time comparison among different types of TLI systems, scarce evidence is now available.…”

Section: Discussionmentioning

confidence: 98%

Does time-lapse imaging have favorable results for embryo incubation and selection compared with conventional methods in clinical in vitro fertilization? A meta-analysis and systematic review of randomized controlled trials

Chen

Wei

et al. 2017

PLoS ONE

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ObjectiveThe present study aimed to undertake a review of available evidence assessing whether time-lapse imaging (TLI) has favorable outcomes for embryo incubation and selection compared with conventional methods in clinical in vitro fertilization (IVF).MethodsUsing PubMed, EMBASE, Cochrane library and ClinicalTrial.gov up to February 2017 to search for randomized controlled trials (RCTs) comparing TLI versus conventional methods. Both studies randomized women and oocytes were included. For studies randomized women, the primary outcomes were live birth and ongoing pregnancy, the secondary outcomes were clinical pregnancy and miscarriage; for studies randomized oocytes, the primary outcome was blastocyst rate, the secondary outcome was good quality embryo on Day 2/3. Subgroup analysis was conducted based on different incubation and embryo selection between groups.ResultsTen RCTs were included, four randomized oocytes and six randomized women. For oocyte-based review, the pool-analysis observed no significant difference between TLI group and control group for blastocyst rate [relative risk (RR) 1.08, 95% CI 0.94–1.25, I2 = 0%, two studies, including 1154 embryos]. The quality of evidence was moderate for all outcomes in oocyte-based review. For woman-based review, only one study provided live birth rate (RR 1,23, 95% CI 1.06–1.44,I2 N/A, one study, including 842 women), the pooled result showed no significant difference in ongoing pregnancy rate (RR 1.04, 95% CI 0.80–1.36, I2 = 59%, four studies, including 1403 women) between two groups. The quality of the evidence was low or very low for all outcomes in woman-based review.ConclusionsCurrently there is insufficient evidence to support that TLI is superior to conventional methods for human embryo incubation and selection. In consideration of the limitations and flaws of included studies, more well designed RCTs are still in need to comprehensively evaluate the effectiveness of clinical TLI use.

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“…Adamson et al studied 319 embryo transfer cycles which were divided to standard morphology alone and TLS and morphologic evaluation (case group). The results showed that implantation rate was 30.2 versus 19.0%, and clinical pregnancy rate was 46.0 versus 32.1%, in case and control groups, respectively (P < 0.05) [4]. In a historical cohort study, it is indicated that three embryo morphokinetics in the irst 48 hours of culture including short duration of the irst cytokinesis, duration of the three-cell stage, and absence of direct cleavage to three cells are associated with developing embryos to highquality blastocysts [5].…”

Section: Arguments Supporting Predictive Value Of Tlsmentioning

confidence: 90%

Embryo Morphokinetics Based on Time-Lapse Observation

Tabibnejad¹

2017

Embryo Cleavage

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Embryo incubation and evaluation are critical steps in assisted reproductive technology (ART). Conventionally, embryo assessment has been done by embryologists through removing embryos from a conventional incubator during the culture period. Over recent years, time-lapse systems (TLS) have been established which can take digital images of embryos at key points and time intervals. This technique allows embryologists to assess the embryo quality in the steady culture environment. According to TLS studies and prepared algorithm models, it seems that TLS alone or in combination with conventional morphology can be considered as a useful diagnostic tool to determine high-quality embryos and improve embryonic implantation and pregnancy rates. In addition, there were remarkable diferences between embryo developmental time points and intervals regarding embryo gender, embryo fragmentation, and type of ovarian stimulation protocol. For conident conclusion, time-lapse imaging should be evaluated in further studies, and the system should be evaluated for cost/beneit ratio efectiveness in individual laboratory.Keywords: embryo cleavage, embryo morphokinetics, embryoscope, time-lapse imaging IntroductionAssisted reproductive technology (ART) may help infertile couples to realize their dream to have a child in their family, but pregnancy and live birth rates following in vitro fertilization (IVF) still remain low. It is ideal to identify viable embryos with the highest implantation potential to raise IVF success rates. In the traditional IVF practice, embryo assessments are mainly based on the morphologic observation and grade of embryologists at each stage of oocyte and embryonic development. Some features including oocyte and embryo quality, blastomere numbers and regularity, the percentage of fragmentation, and cytoplasmic granularity have been deined as prognostic indicators of successful pregnancy. This traditional embryo assessment method may have some detrimental efects on embryo growth because frequently opening and closing of incubators often cause to the change of embryo culture environmental steadiness. In order to reduce the inter-and intra-observer diference change, the time-lapse imaging (TLI) has been introduced into in vitro fertilization (IVF) laboratory. The application of time-lapse technology to the clinical IVF laboratory has supported more detailed observations on the embryo development researches quickly.The aim of this chapter is to determine whether TLI is useful for selection of "top quality" embryos for transfer to improve ART outcome rather than conventional morphological evaluation. The possible correlation between embryos' sex, embryo fragmentation, treatment protocols, diferent culture media, and embryo morphokinetics will be examined based on some new researches of TLI facilities. Furthermore, various algorithms and predictive models designed in ART cycles with TLI will be discussed.

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Improved implantation rates of day 3 embryo transfers with the use of an automated time-lapse–enabled test to aid in embryo selection

Cited by 85 publications

References 25 publications

High sperm DNA fragmentation delays human embryo kinetics when oocytes from young and healthy donors are microinjected

High sperm DNA fragmentation delays human embryo kinetics when oocytes from young and healthy donors are microinjected

Does time-lapse imaging have favorable results for embryo incubation and selection compared with conventional methods in clinical in vitro fertilization? A meta-analysis and systematic review of randomized controlled trials

Embryo Morphokinetics Based on Time-Lapse Observation

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