Time-Lapse Microscopy for Embryo Culture and Selection

Abstract

Elective single-embryo transfer has emerged as the most effective method for reducing the incidence of multiple births associated with assisted-reproductive technology (ART). Over the last several years, time-lapse microscopy (TLM) has been introduced as a tool in the ART laboratory to assist in choosing the most competent embryo. TLM allows for continuous noninvasive monitoring and evaluation of embryo morphology and morphokinetics (i.e., the precise timing of specific morphologic occurrences). To date, over 20 morphokinetic markers have been identified with the use of TLM, some of which have been shown to be highly predictive of blastocyst developmental potential. Others have been identified as potential markers for implantation potential and for aneuploidy. In this chapter, we provide an overview of TLM, introduce the capabilities of the technology, review the literature on the potential use of TLM to predict blastocyst formation, implantation, and live-birth potential, and discuss the effects of various factors on morphokinetic parameters. Based on the existing literature, we believe that TLM may evolve as an effective adjunct laboratory technique, although it is unlikely to supplant existing standards of care for embryo evaluation. However, more research needs to be performed to validate existing models and to prove the true value of TLM for embryo selection.