Management Intercultural (Dec 2016)
TIME-LAPSE MICROSCOPY ROLE IN IMPROVING THE OUTCOME OF IVF/ICSI CYCLES BY MONITORING AND SELECTION OF EARLY EMBRYO
Abstract
In vitro fertilization (IVF) and intracytoplasmatic sperm injection (ICSI) are well-established assisted reproductive biotechnologies used to overcome infertility in couples. Time-lapse monitoring is an imagistic technology which was elaborated to fulfill the need for observing the dynamics of the mammalian embryonic development in a continuous, non-invasive manner, without removing the embryos from the optimal culturing conditions. This technology offers unique information regarding the cleavage process, as well as morphological and structural modifications thus enabling the embryologists to select the embryos with elevated implantation potential. Aim of the study: to identify, evaluate and summarize the available data regarding the role of time-lapse microscopy in improving the outcome of IVF and ICSI by monitoring and selection of early embryos Material and methods: we systematically reviewed the available evidence regarding the assessment of embryo quality through both conventional monitoring and time-lapse microscopy for couples undergoing in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). The meta analysis included randomized trials and published data encountered on ISI Web of Knowledge Science, MedLine and Pubmed using the following keywords: time-lapse microscopy, IVF, ICSI, embryo, outcome, pregnancy. As criteria of differentiation, only studies that reported information regarding the implantation rate, aspects regarding clinical pregnancy or live birth were considered for analysis. Results: the info from the studies was extracted and included in the meta-analysis. A part of the retrospective studies conducted after 2010 have highlighted a correlation between time-lapse parameters and embryo viability as defined by the developmental competence and subsequently by the confirmation of clinical pregnancy. Other authors undertook a critical appraisal on potential benefit time-lapse monitoring may bring to ART. Conclusion: Even if time-lapse monitoring is likely to revolutionize the field of embryology by enabling an objective, automatize monitoring and selection of embryos, further randomized studies reporting clinical outcomes after IVF and ICSI are needed before adopting this technology for routine use in the laboratory.
