Obstetrics & Gynecology · 2 h ago
Time-lapse embryo imaging does not improve IVF live birth rates
An individual participant data meta-analysis of eight randomized trials involving 5,642 patients found no clinically important difference in live birth rates with time-lapse imaging compared with standard embryo incubation and selection. Results were similar for undisturbed culture and morphokinetic-based embryo selection considered separately.
- Eight-trial IPD analysis included 5,642 participants.
- Overall TLI showed no meaningful live birth advantage.
- Findings were similar across TLI approaches and subgroups.
- Other reported pregnancy and birth outcomes were comparable.
Time-lapse imaging (TLI) is used during IVF or ICSI to culture embryos without disturbance and, in some systems, to guide embryo selection using developmental timing. This individual participant data meta-analysis included randomized trials in women undergoing IVF/ICSI. Data from eight trials (5,642 participants) were included in the primary analysis; aggregate data from a further eight trials were used in sensitivity analyses. The primary outcome was live birth after the first fresh or frozen embryo transfer.
For overall TLI, live birth odds were similar to standard incubation and selection (four trials, 2,913 participants; adjusted odds ratio 0.97, 95% CI 0.81–1.15; adjusted absolute risk difference −0.7%, 95% CI −4.9% to 3.4%). Findings were also similar for undisturbed versus disturbed culture and for morphokinetic versus standard embryo selection. The analysis found no evidence that effects on live birth differed by age, culture duration, transfer day, or fresh versus frozen transfer. Other reported outcomes, including miscarriage, clinical pregnancy, birthweight, and gestational age, were also similar.
The authors rated the evidence for live birth as high certainty and concluded that TLI does not confer a clinically important improvement in reproductive outcomes. These findings may inform clinical practice and guideline development; the abstract reports no concern about risk of bias in the trials contributing individual data.
In practice
For women undergoing IVF/ICSI, this individual participant data meta-analysis found no clinically important live birth benefit from time-lapse imaging compared with standard incubation and embryo selection. The finding applied to overall TLI, undisturbed culture, and morphokinetic-based selection, with no detected variation by age or transfer characteristics. The authors rated the live birth evidence as high certainty, and other reported pregnancy and birth outcomes were similar. These findings do not support expecting improved reproductive outcomes from TLI, although they do not establish effects on outcomes not reported in the abstract.
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Human Reproduction Update: Does time-lapse imaging (TLI) of embryos improve reproductive outcomes in in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI)? Individual participant data (IPD) meta-analysis ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.