Enter the latest technology for use in the embryology laboratory: embryo imaging systems. Currently there are three different systems in use that utilize a video system to capture frequent images of the developing embryos without ‘disturbing’ them. These images are stored and can be reviewed to select embryos for transfer. Only one of the three systems gives a “transfer” or “don’t transfer” result based on a propriety scientific algorithm. The other two rely on clinic based algorithms to determine transfer status of embryos.
Each system has live births from embryos cultured using the imaging systems, although these pregnancies fall under the auspices of “clinical trial” or experimental data. Recently, one system announced the first birth from use of the system. This birth resulted from clinical not experimental use of the system. A number of births are expected this month from clinical use of imaging systems.
The first, and probably the most important advantage is that embryos do not have to be removed from the incubator to assess them. There is a wealth of research indicating that embryos are extremely sensitive to changes in temperature and pH. Even in the most tightly regulated laboratory system, the possibility of slight changes in temperature is real each time embryos are removed from the incubator to assess their status.
The second advantage is that the cleavage patterns of the embryos can be evaluated. For example an embryo that cleaves from one cell directly to a three cell stage, followed by a four cell stage has been found to not be as viable as an embryo that cleaves from one cell to two cell stage to four cell stage. Unless the physical (old fashioned) assessment took place at exactly the right moment, the three cell stage could easily be missed.
Another benefit is in the search for singletons. The new imaging systems are another tool in the IVF tool kit to assist in establishing a singleton pregnancy through SET (single embryo transfer) instead of risking multiple births transferring two or more embryos.
As more centers utilize this technology, the paradigms of good embryos and poor embryos will become more developed and understood. The embryo selection process will be enhanced with the additional knowledge, ultimately resulting in a better outcome for our patients.