Abstract
Time-lapse systems (TLS) and associated algorithms are interesting tools to improve embryo selection. This study aimed to evaluate how TLS and KIDScore™ algorithm changed our practices of embryo selection, as compared to a conventional morphological evaluation, and improved clinical pregnancy rates (CPR). In the study group (year 2020, n = 303 transfers), embryos were cultured in an EmbryoScope+ time-lapse incubator. A first team observed embryos conventionally once a day, while a second team selected the embryos for transfer based on time-lapse recordings. In the control group (year 2019, n = 279 transfers), embryos were selected using the conventional method, and CPR were recorded. In 2020, disagreement between TLS and the conventional method occurred in 32.1% of transfers, more often for early embryos (34.7%) than for blastocysts (20.5%). Irregular morphokinetic events (direct or reverse cleavage, multinucleation, abnormal pronuclei) were detected in 54.9% of the discordant embryos. When it was available, KIDScore™ was decreased for 73.2% of the deselected embryos. Discordant blastocysts mainly corresponded with a decrease in KIDScore™ (90.9%), whereas discordant Day 3 embryos resulted from a decreased KIDScore™ and/or an irregular morphokinetic event. CPR was significantly improved in the TLS group (2020), as compared to the conventional group (2019) (32.3% vs. 21.9%, p = 0.005), even after multivariate analysis. In conclusion, TLS is useful to highlight some embryo development abnormalities and identify embryos with the highest potential for pregnancy.
Highlights
Embryo selection for transfer is a crucial step in the Assisted Reproductive Technology (ART) process and remains dependent on the morphological assessment of embryos
The present study aims to evaluate how time-lapse technology and KIDScoreTM use have changed our current practices of embryo selection for transfer, in comparison with the conventional morphological evaluation, and contributed to improving pregnancy outcomes in in vitro fertilization (IVF)
We investigated the contribution of continuous monitoring provided by time-lapse system (TLS) and KIDScoreTM result on the embryo selection process (2020)
Summary
Embryo selection for transfer is a crucial step in the Assisted Reproductive Technology (ART) process and remains dependent on the morphological assessment of embryos. Some studies observed significantly higher clinical pregnancy [18,28,29,30] and live birth rates [30,31,32,33,34] with TLS in comparison with conventional incubators and standard morphological evaluation, while other investigators found no significant differences between the two systems [8,35,36,37,38]. Changes in the strategy employed for ranking embryos when using TLS have been minimally explored [39] In this context, the present study aims to evaluate how time-lapse technology and KIDScoreTM use have changed our current practices of embryo selection for transfer, in comparison with the conventional morphological evaluation, and contributed to improving pregnancy outcomes in IVF
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