Which embryo selection method should be offered to the patients?

Kovács, Péter; Lieman, Harry

doi:10.1007/s10815-019-01443-8

Cited by 11 publications

(5 citation statements)

References 9 publications

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“…Despite the ever-growing interest in this field, the use of this technology to improve clinical outcomes remains controversial. [4][5][6] The present review aims to summarize the state of the art concerning the clinical use of TLT in the field of human reproduction. The interest in the applicability of TLT in the field of human embryo development is still intense, and the number of publications on this topic in the last decade has remained constant ( Figure 1).…”

Section: Introductionmentioning

confidence: 99%

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The clinical use of time-lapse in human-assisted reproduction

Minasi

Greco

Varricchio

et al. 2020

Clin Med�Insights�Reprod�Health

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A major challenge in the assisted reproduction laboratory is to set up reproducible and efficient criteria to identify the embryo with the highest developmental potential. Over the years, several methods have been used worldwide with this purpose. Initially, standard morphology assessment was the only available strategy. It is now universally recognized that besides being a very subjective embryo selection strategy, morphology evaluation alone has a very poor prognostic value. More recently, the availability of time-lapse incubators allowed a continuous monitoring of human embryo development. This technology has spread quickly and many fertility clinics over the world produced a remarkable amount of data. To date, however, a general consensus on which variables, or combination of variables, should play a central role in embryo selection is still lacking. Many confounding factors, concerning both patient features and clinical and biological procedures, have been observed to influence embryo development. In addition, several studies have reported unexpected positive outcomes, even in the presence of abnormal developmental criteria. While it does not seem that time-lapse technology is ready to entirely replace the more invasive preimplantation genetic testing in identifying the embryo with the highest implantation potential, it is certainly true that its application is rapidly growing, becoming progressively more accurate. Studies involving artificial intelligence and deep-learning models as well as combining morphokinetic with other non-invasive markers of embryo development, are currently ongoing, raising hopes for its successful applicability for clinical purpose in the near future. The present review mainly focuses on data published starting from the first decade of 2000, when time-lapse technology was introduced as a routine clinical practice in the infertility centers.

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Section: Introductionmentioning

confidence: 99%

“…Despite the ever-growing interest in this field, the use of this technology to improve clinical outcomes remains controversial. 4 – 6 …”

Section: Introductionmentioning

confidence: 99%

The clinical use of time-lapse in human-assisted reproduction

Minasi

Greco

Varricchio

et al. 2020

Clin Med�Insights�Reprod�Health

View full text Add to dashboard Cite

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“…On that context, Scotland represents a rare scenario: the government allocated in 2014 special funds for public IVF centres, and all of them invested in TLM and are currently using this technology to culture human embryos (NHS-Scotland, National Health Service https://www.scot.nhs.uk). However, even thought TLM is quickly spread in many IVF centres worldwide, its application, to improve clinical outcomes, remains questionable [Lundin and Park, 2020;Kovacs and Lieman, 2019;Armstrong et al, 2019]. Therefore, we highlight here some advantages of this practice.…”

Section: Current Status Of Time-lape Technologymentioning

confidence: 96%

Focus on time-lapse analysis: blastocyst collapse and morphometric assessment as new features of embryo viability

Sciorio

Meseguer²

2021

Reproductive BioMedicine Online

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“…Confounding factors such as culture conditions (culture medium, O 2 concentration), day of transfer, the number of embryos transferred, fresh or frozen embryo used, oocyte source, patient population, the TLS type and algorithms to predict various clinical outcomes, were inconsistent among the included studies. 12 Moreover, these studies were at high risk of bias for randomisation and allocation concealment, thus results should be interpreted with extreme caution. Notably, most of the studies investigated patients with normal ovarian response or good prognosis, and only one pilot RCT has been conducted on the effectiveness of TLSs in patients with poor prognosis.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 98%

Embryo incubation by time-lapse systems versus conventional incubators in Chinese women with diminished ovarian reserve undergoing IVF/ICSI: a study protocol for a randomised controlled trial

Chen

Huang

et al. 2020

BMJ Open

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IntroductionThe time-lapse imaging system (TLS) is a newly developed non-invasive embryo assessment system. Compared with conventional incubators, a TLS provides stable culture conditions and consistent observations of embryo development, thereby potentially improving embryo quality and selection of the best quality embryo. Although TLSs have been routinely used in many in vitro fertilisation (IVF) centres globally, there is insufficient evidence to indicate that TLSs result in higher cumulative live birth rates over conventional incubators. The purpose of this study is to compare the cumulative live birth rates and safety including miscarriage in infertile patients with diminished ovarian reserve (DOR) from both TLSs and conventional incubators.Methods and analysisThis study is a double-blind randomised controlled clinical trial (1:1 treatment ratio of TLSs vs conventional incubator). A total of 730 patients with DOR undergoing the first or second cycle of IVF or intracytoplasmic sperm injection (ICSI) will be enrolled and randomised into two parallel groups. Participants will undergo embryo culture in the TLSs (group A) or the conventional incubators (group B), respectively. Embryos are selected for transfer in both groups by the morphological characteristics. The embryo selection algorithm software is not used in the TLSs. The primary outcome is the cumulative live birth rate of the trial IVF/ICSI cycle within 12 months after randomisation. This study is powered to detect an absolute difference of 10% (35% vs 25%) at the significance level of 0.05% and 80% statistical power based on a two-sided test.Ethics and disseminationThis trial has been approved by the Institutional Ethical Committee of Shanghai First Maternity and Infant Hospital (KS1958). All participants in the trial will provide written informed consent. The study will be conducted according to the principles outlined in the Declaration of Helsinki and its amendments. Results of this study will be disseminated in peer-reviewed scientific journals.Trial registration numberChinese Clinical Trial Registry (ChiCTR1900027746).

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Which embryo selection method should be offered to the patients?

Abstract: Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Cited by 11 publications

References 9 publications

The clinical use of time-lapse in human-assisted reproduction

The clinical use of time-lapse in human-assisted reproduction

Focus on time-lapse analysis: blastocyst collapse and morphometric assessment as new features of embryo viability

Embryo incubation by time-lapse systems versus conventional incubators in Chinese women with diminished ovarian reserve undergoing IVF/ICSI: a study protocol for a randomised controlled trial

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