Time lapse monitoring of embryos during culture is being used increasingly to achieve optimal culture conditions, improved embryo selection, quality control, and more efficient workflow in the laboratory. Since 2015, two EmbryoScope™ (ES-D) devices, each with a capacity to monitor up to 12 embryos from 6 patients have been used in our clinic. In order to allow for time lapse monitoring during the entire incubation period for all our patients, we installed five units of the new EmbryoScope+™ (ES+) device in 2017. One ES+ unit can monitor up to 16 embryos from a total of 15 patients simultaneously. Due to the increased capacity of the ES+, the number of “door” openings of the incubator have increased compared to the ES. However, the ES+ incubator has also been re-configured so that only the embryo slides taken out of the incubator are ejected from the controlled environment, leaving remaining slides concealed inside the incubator. One additional difference between the two systems is that the embryos in the dish for ES+ share media overlay, whereas, the embryos in the ES dish are completely isolated from each other. In this study, we compared outcomes between the two incubator types as we migrated from the ES-D to the ES+. A prospective study We targeted 776 mature ova in 73 cycles from which at least six oocytes were retrieved between January and February 2017 for investigation. After insemination, embryos from each patient were allocated to two groups and incubated in an ES-D (ES group) or an ES+ (ES+ group). We compared fertilization rate, cleavage rate, Day-3 good-quality embryo rate, Day-5 blastocyst formation rate, Day-5 good-quality blastocyst rate, and Day-6 blastocyst formation rate between the ES-D and ES+ groups. Our findings revealed for the ES-D versus the ES+ group a fertilization rate of 85.8% versus 83.0%, cleavage rate 100% versus 97.5%, Day-3 good-quality embryo rate 70.6% versus 74.5%, Day-5 blastocyst formation rate 62.2% versus 69.4%, Day-5 good-quality blastocyst rate 37.5% versus 44.2%, and Day-6 blastocyst formation rate 9.8% versus 5.6%, respectively. There was no significant difference between the two groups in these parameters. The outcomes with the two time-lapse incubation and imaging systems showed no statistical difference in the present study; even though, the new ES+ device tended to yield higher blastocyst formation than the ES-D. The ES+ provides an incubation environment that is at least equivalent or superior to that of the ES-D, ES-D occupied area per patient was 562.8 cm2 per patient and , ES + was 220.0 cm2 per patient, and has more than double the capacity of the ES-D. Thus, the ES+ is shown to be a highly attractive upgrade for a busy lab such as ours.
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