Year: 2015
Type: conference-abstract
Abstract: Time-lapse technology was introduced following an inductive rationale even before robust data have proved efficacy. We aimed to identify and appraise all evidence on embryo time-lapse imaging following IVF/ICSI. Systematic review of RCTs comparing either/both time-lapse incubator/embryo selection with standard incubator/embryo selection. We searched 6 databases. We included 4 RCTs. Three investigated the effect of both the time-lapse incubation system and selection; they revealed low-quality evidence of a benefit on ongoing pregnancy (RR 1.20; 95%CI 1.05–1.37). Evidence quality was downgraded because of high risk of bias in the included RCTs and of imprecision. One RCT investigated the effect of only the time-lapse incubation system, without use of imaging information for embryo selection. It revealed a non-significant negative effect of this intervention on ongoing pregnancy (RR, 0.71; 95% CI 0.49–1.03). The available evidence is insufficient to support use of time-lapse compared with conventional evaluation for embryo selection. Future trials are necessary and should be encouraged. We believe an ideal RCT would be designed to evaluate 3 arms: (A) time-lapse incubation system and embryo selection with time-lapse markers; (B) standard incubation system and embryo selection with standard morphology criteria; (C) time-lapse incubation system but with standard embryo selection. Therefore, when comparing groups A and B, the effect of both time-lapse incubation and selection would be investigated; when comparing groups A and C, the effect of only time-lapse embryo selection would be investigated; and when comparing groups B and C, the effect of only time-lapse incubation system would be investigated. We hope that well-designed RCTs will be undertaken improving the quality of the evidence regarding the efficacy and safety of time-lapse imaging for embryo selection, as well as some cost analysis; this would permit couples and health care providers to take evidence-based decision regarding its use or not.
DOI: 10.1002/uog.15280
Authors: C. Racowsky, P. Kovacs, W.P. Martins
Institutions: Harvard University, Kaali Institute, Universidade de São Paulo
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2176107158