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Questioning alleged benefits of time-lapse imaging in IVF

Women’s health experts at the University of Liverpool have found no evidence to suggest costly timelapse imaging improves the chance of successful pregnancies through in vitro fertilisation (IVF).

Timelapse imaging machines create digital pictures of developing embryos within their inbuilt incubators every 5–15 min from the time of IVF up to embryo transfer. This creates a time-lapse sequence allowing clinicians to visualise embryo development on an external monitor.

One in six adults are affected by infertility worldwide. Assisted reproductive techniques, including IVF, have been at the forefront in helping these couples have a baby. Increasingly, technologies such as time lapse imaging have been offered to improve pregnancies and live birth rates.

Time-lapse imaging systems are offered for their supposed benefits including: minimised environmental fluctuations that might arise from the intermittent removal of embryos for assessment and a greater likelihood of seeing abnormal embryonic development. However, published evidence has found these systems, which can cost up to £150,000 and are claimed to reduce the time it takes to get pregnant, cannot improve the cumulative chance of live birth when all embryos have been transferred during an IVF cycle.

Researchers did a 3-arm randomised trial comparing time-lapse imaging systems providing undisturbed culture and embryo selection, and time-lapse imaging systems providing only undisturbed culture, and compared each with standard care on live birth rates. They randomly allocated 1575 couples undergoing IVF or ICSI treatment (Intracytoplasmic Sperm Injection, a treatment that involves injecting live sperm directly into a person’s eggs in a laboratory) in the UK and Hong Kong.

Shakila Thangaratinam, Professor of Women’s Health said: “Our trial comprehensively shows that NHS resources need not be expended on technologies like time lapse imaging systems for the purpose of improving live birth rates in couples undergoing IVF treatment.

“Further work is now needed to know if there is a place for time lapse imaging system to select embryos in women at risk of having babies with chromosomal problems, e.g., older women.”

The paper, ‘Clinical effectiveness and safety of time-lapse imaging systems for embryo incubation and selection in in-vitro fertilisation treatment (TILT): a multicentre, three-parallel-group, double-blind, randomised controlled trial’ was published in The Lancet (DOI: https://doi.org/10.1016/S0140-6736(24)00816-X)

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