According to the results of the largest trial of its kind, there is no difference in live birth rates between time-lapse imaging and other standard approaches used in in vitro fertilization (IVF) for incubation and selection of embryos before implantation.
The randomised controlled trial looked at IVF outcomes in the UK and Hong Kong. The results, published today in The Lancet, provide much-needed evidence that the use of time-lapse imaging (TLI) does not improve treatment outcomes for a person undergoing fertility treatment.
Time-lapse imaging is a technique used in IVF that takes thousands of time-lapse images of embryos as they grow, creating a continuous view of each embryo as it develops. Some fertility practitioners offer time-lapse imaging as a preimplantation screening technique and believe that the information provided by time-lapse imaging, such as the rate of development or the number and appearance of cells, can help select the best embryos for implantation.
In TLI, embryos are not removed from their incubator, minimizing fluctuations in temperature, humidity, pH, and gas concentrations that could affect development. Standard techniques for evaluating and selecting embryos with the best implantation potential require that the embryo be removed from the incubator.
The double-blind trial, led by Dr Priya Bhide of the Women’s Health Research Unit at Queen Mary University of London and funded by Barts Charity and others, recruited more than 1,500 participants undergoing IVF at seven centres in the UK and Hong Kong.
Participants were randomly assigned to one of three trial groups: one group of participants underwent embryo selection based on ILT, one group underwent standard static assessment using undisturbed culture, and the third group underwent conventional assessment using a light microscope and standard embryo culture in standard incubators. Baseline demographic and clinical characteristics of participants were similar across the three groups.
Live birth rates for embryos in each study group were 33.7% in the TLI group, 36.6% in the undisturbed culture group, and 33.0% in the control group. Clinical pregnancy rates were 42.2% in the TLI group, 43.4% in the undisturbed culture group, and 40.9% in the control group. None of the other secondary clinical efficacy and safety endpoints demonstrated significant differences between groups.
Dr Priya Bhide, Clinical Lecturer in the Women’s Health Research Unit at the Centre for Public Health and Policy at the Wolfson Institute for Population Health, said: “Our trial suggests that ILT does not improve the chances of live birth in women undergoing IVF and ICSI. This shows that the theoretical benefits of advanced technologies do not always translate into better clinical outcomes. This is important information for all stakeholders: patients, healthcare professionals, funders and policy makers.”
Dr David Chan, Laboratory Director at the Prince of Wales Hospital, The Chinese University of Hong Kong, said: “Our trial provides evidence that TLI machines may not be essential equipment in IVF laboratories, especially for resource-limited IVF laboratories. Laboratories can use the results of this study to re-evaluate how they allocate their budget for equipment. Instead of investing heavily in the TLI machine, they could focus more on laboratory equipment that has a direct and measurable impact on live birth rates. This approach could help to strike a better balance between the overall cost of IVF treatments and affordability for patients in resource-limited settings.”
One in six adults worldwide is affected by subfertility. Statistics from the Human Fertilisation and Embryology Authority (HFEA) shows that more than 100,000 IVF treatments took place in the UK between 2022 and 2023.
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