Highlights
- •Time-lapse systems significantly improved the first embryo transfer implantation rate.
- •Time-lapse systems did not significantly improve the cumulative implantation rate.
- •Time-lapse systems did not significantly improve the live birth rate.
Abstract
Research question
What are the potential clinical benefits of embryo culture and assessment in a time-lapse
incubator compared with a standard incubator using static assessment?
Design
This large multicentre, single-blinded, randomized controlled study included 1224
participants randomly assigned (1:1) to the time-lapse or standard incubator group.
In all patients one or two embryos were transferred on day 3. The primary outcome
was the implantation rate in the first embryo transfer cycle. Secondary outcomes included
the cumulative implantation rate, live birth rate in the first embryo transfer cycle
and cumulative live birth rate.
Results
Among 1224 participants recruited, 1182 underwent embryo transfer. The number of successfully
implanted embryos in the first transfer cycle was significantly higher in the time-lapse
incubator group (time-lapse group: 52.35%, standard incubator group: 47.11%, P = 0.014). The implantation rate in the first embryo transfer cycle was still significantly
higher in the time-lapse group than the standard incubator group after adjusting for
age, body mass index, medical centre and embryo status (relative risk 1.11, 95% confidence
interval 1.02–1.20, P = 0.020). However, the cumulative implantation rate, live birth rate in the first
embryo transfer cycle and cumulative live birth rate were not statistically different
between the groups.
Conclusions
The implantation rate in the first embryo transfer cycle was significantly improved
in the time-lapse group, but the effect of the time-lapse system on the cumulative
implantation rate or cumulative live birth rate was not significant. The embryo assessment
method offered by time-lapse systems rather than an undisturbed environment may play
an important role in improving the implantation rate in the first embryo transfer
cycle. These results are only applicable to young patients.
Keywords
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Biography
Xiaodong Zhang graduated from Southwest Medical University, Sichuan, China. He has been engaged in reproductive medicine for more than 10 years at Chongqing Health Center for Women and Children, mainly responsible for embryonic development-related research. His current research areas are embryo assessment, artificial intelligence and reproductive biology.
Key message
The study found that embryo incubation, evaluation and selection using a time-lapse system compared with standard culture led to significantly higher implantation rates in the first embryo transfer cycle in good-prognosis patients, while the cumulative implantation and live birth rates remained unchanged.
Article info
Publication history
Published online: June 27, 2022
Accepted:
June 20,
2022
Received in revised form:
June 9,
2022
Received:
February 7,
2022
Declaration: The authors report no financial or commercial conflicts of interest.Footnotes
Preliminary data from this trial were first presented at the 2020 ASRM Scientific Congress.
Identification
Copyright
© 2022 Published by Elsevier Ltd on behalf of Reproductive Healthcare Ltd.
