PREDICTIVE CUMULATIVE LIVE-BIRTH RATE BASED ON FACTOR OF SURVIVAL RATE FOR SUBSEQUENT CYCLE IN UNDISTURBED EMBRYO CULTURE IN TIME-LAPSE INCUBATOR, DOES POOLING EFFECT THE LIVE BIRTH RATE IN TIME-LAPSE INCUBATOR?

Abstract

Time-Lapse (TL) incubators are widely used in IVF laboratories. There are basically 2 kind of TL incubators, one of them uses Individual well such as EmbryoScope® and the second one uses pool culture medium such as EmbryoScope+® from Vitrolife and Geri® from Genea Biomedx. There are some studies that compare the conventional benchtop incubator to TL incubator in terms of live birth (LB), but the concept of pool culture medium in TL incubator came into existence in last few years. Therefore, we have performed this study to analyze the results of Geri® and EmbryoScope+® with EmbryoScope® in terms of cumulative live birth to know the efficacy and efficiency of TL incubator in terms of LB and know the effect of pooling on LB. There is no proper consensus about cumulative live birth as not all the patients go for next transfer cycle for different reasons. We have only considered the patients who started the treatment at IVI with TL incubator EmbryoScope® (n=1319 with an average oocyte age of 30.03), Geri® (n=669 with an average oocyte age of 29.38) and EmbryoScope+® (n=994 with an oocyte age of 29.54) from first cycle, no history of prior treatment at IVI before. We collected oocyte from patients and donors. We have performed ICSI for all the MII aspirated in the cycle. All the oocytes were cultured in TL incubator with single step culture medium. We have only considered the data from 2016 to March 2020 for LB, for implantation rate we have considered data up to February 2021. The transfer was done in blastocyst stage. Supernumerary viable blastocysts were vitrified and devitrified for later frozen-thawed transfer. We have used predictive cumulative birth based on parameter of survival rate (which is based on how many percentage of people are left with no live birth in each transfer cycle). In EmbryoScope® we had LB rate of 42.11% for the first transfer of first cycle (fresh and frozen) and it increased significantly in subsequent transfers resulting into 61.50% cumulative birth rate for second transfer of first cycle and 75.27% cumulative birth rate for third transfer of cycle, whereas the cumulative birth rate was higher in EmbryoScope+® and Geri® incubator resulting into 79.72% and 80.96% respectively in the 3rd transfer of the cycle. Implantation rate was almost similar in Geri® (66.21%) and EmbryoScope® (65.42%) but was higher in EmbryoScope+® (70.62%). We also compared the result of autologous cycles (AC) and donor cycles (DC) where the DC resulted in higher number of live births in Geri® (42.46%(AC), 46.48%(DC)) and EmbryoScope® (40.12%(AC),45.11%(DC)) and result was almost similar in EmbryoScope+® (47.53%(AC) and 48.14%(DC)). The live birth results of TL incubator with individual well and pool medium was almost comparable, being a little higher in pool medium. The live birth was also higher in donor cycle compared to autologous cycle.