IVF time-lapse imaging does not improve live birth rate

A large-randomised control, double-blind clinical trial spanning seven centres in the UK and Hong Kong has concluded that IVF time-lapse imaging does not contribute to increasing live birth rate.

Time-lapse imaging involves digital imaging of the developing in vitro embryos kept in an incubator. This imaging takes place every five to fifteen minutes meaning the embryos can be evaluated and monitored remotely. Clinics offering this approach as an add-on claim it improves on the traditional approach of IVF, during which embryos have to be taken out of the incubator to be evaluated and monitored (see BioNews 1240), by allowing them to develop undisturbed and improving embryo selection.

'Our trial suggests that time-lapse imaging does not improve the odds of live birth in women having IVF and ICSI treatments. This shows that the theoretical benefits of advanced technology do not always translate into improved clinical outcomes,' said lead author Dr Priya Bhide from the Women's Health Research Unit at Queen Mary, University of London.

The trial was conducted with 1575 women between the ages of 18 to 42 from seven different centres (1185 from the UK and 390 from Hong Kong) undergoing IVF. The women had to be split into three groups of 525 – the first group's embryos received time-lapse imaging where specific imaging variables were used for embryo selection, the second group received standard time-lapse imaging in which the embryos simply remained undisturbed, and the final group received the traditional treatment where embryos had to be taken out of the incubator to be monitored.

The primary aim of the study was to assess the amount of live births achieved after IVF. The number of births did not significantly vary between the three groups of women (33.7 percent for the extended time-lapse imaging group, 36.6 percent in the standard time-lapse imaging group, and 33.0 percent in the traditional treatment group), hence the trial concluded that time-lapse imaging did not improve IVF success rate in the studied group of women.

'Laboratories may use the findings from this study to re-evaluate how they allocate their budget for equipment,' said Dr David Chan, lab director at the Prince of Wales Hospital in the Chinese University of Hong Kong. 'Instead of investing heavily in the time-lapse imaging machine, they could focus more on lab equipment that has a direct, measurable impact on live birth rates. This approach could help strike a better balance between the overall cost of IVF treatments and patient affordability in resource-limited settings'.

The study mentions that these conclusions are based on the current time-lapse imaging methods that are in use, and the benefits of time-lapse imaging could change if the technology improves in the future.

Sarah Norcross, director of PET (the Progress Educational Trust), which publishes BioNews, said: 'For more than a decade, we have seen claims that using time-lapse imaging for embryo selection can improve the chance of a live birth by 50 percent or more.

'Finally, we have a thoroughgoing, double-blind, randomised controlled trial that can detect meaningful differences in live births, when time-lapse imaging is used for embryo culture and selection. Importantly this trial has found that time-lapse seems to make no difference.

'The lesson here is that patients should be sceptical, whenever any claim is made that any technology or add-on can improve chances of IVF success. Certainly, clinics should not be charging patients extra for fertility treatment if time-lapse imaging is used.'