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Published on: March 19, 2019
Influence of incubator type on embryo development and clinical outcomes: A retrospective cohort study comparing
D C Kieslinger1, S C M Scholtenhave1, E H Kostelijk1
1Amsterdam UMC Location Vrije Universiteit Amsterdam, IVF Center, Amsterdam, the Netherlands.
Research Question:
Do embryo development and pregnancy outcomes differ between patients whose embryos were cultured in a time-lapse benchtop incubator compared to a conventional big box incubator?
Design:
Clinical outcomes of 2,198 patients whose embryos were cultured in a time-lapse benchtop incubator or a conventional big box incubator were compared retrospectively. Patients undergoing their first IVF or ICSI cycle between 2017-2020 were included. To account for baseline differences and potential confounding factors, inverse probability weighting (IPW) was applied. The confounders used are: female age, number of oocytes collected, treatment type, and number of embryos transferred.
Results:
Baseline imbalances observed in the raw data were successfully minimized after weighting with IPW, resulting in well-balanced groups. The primary outcome was defined as ongoing pregnancy rate (fetal heartbeat at 10-12 weeks). No significant differences were observed between the time-lapse benchtop group (n = 843) and big box group (n = 1355) for ongoing pregnancy rate (33.1% vs 31.9%) [IPW OR 1.00; 95% CI 0.82 to 1.21] or any other pregnancy outcome. The rate of transferred embryos displaying early cleavage on day 1 and optimal development on day 2 did not differ significantly. While the percentage of transferred embryos with ≥ 7 blastomeres on day 3 was significantly lower in the time-lapse benchtop group (87.1% vs 93.0%) [IPW OR 0.46; 95% CI 0.34 to 0.63], significantly more embryos were available for cryopreservation (59.5% vs 51.7%) [IPW mean difference 5.2; 95% CI 2.1 to 8.2].
Conclusions:
In a well-controlled IVF laboratory environment, despite differences in intermediate laboratory outcomes, no differences in clinical success after fresh embryo transfer were observed between time-lapse benchtop and big box incubator systems.
Key Message:
Our study indicates that the use of time-lapse benchtop incubators does not improve pregnancy outcomes compared with conventional big box incubators. Given the increasing adoption of time-lapse benchtop incubators, further evaluation of cumulative pregnancy outcomes and cost-effectiveness is needed to advance the responsible use of limited healthcare resources.
