Live birth rate following undisturbed embryo culture at low oxygen in a time-lapse incubator compared to a high-quality benchtop incubator

Time-lapse (TL) incubators are increasingly used in in vitro fertilization (IVF) laboratories but there have been few studies of their effectiveness in comparison to other incubator types. Moreover, the design of most studies has been limited by the quality of the control incubator. We have therefore performed a one-year pseudo-randomized prospective study of IVF cycles using a TL incubator (EmbryoScope™) (n = 243) or a conventional incubator (K-System G-185 Flatbed) (n = 203). The two groups were well matched in terms of clinical parameters: IVF cycle attempt number, IVF/ICSI, age, number and day (3 or 5) of embryo transfer. Embryos were selected for transfer using conventional (non-TL) morphological grading. The EmbryoScope group had an increased chance of a live birth (43.2% vs. 34.5%; OR = 1.43 [95%CI: 0.96-2.13]) with significantly reduced early pregnancy loss (5.8% vs. 13.8%; OR = 0.37 [0.19-0.74]) compared to the K-System incubator. There was a higher proportion of 4-cell embryos on day 2 and 8-cell embryos on day 3 in the EmbryoScope, compared to the K-Systems. The use of TL incubators is appropriate in ART by virtue of their high specification, facility for low oxygen culture and provision of minimally disturbed culture conditions which limit exposure of human embryos to environmental stress.