title: A randomized clinical trial comparing embryo culture in a conventional incubator with a time-lapse incubator.
abstract: OBJECTIVE
  Time-lapse monitoring allows for a flexible embryo evaluation and potentially provides new dynamic markers of embryo competence. Before introducing time-lapse monitoring in a clinical setting, the safety of the instrument must be properly documented. Accordingly, the aim of this study was to evaluate the safety of a commercially available time-lapse incubator.
  
  
  METHODS
  In a two center, randomized, controlled, clinical trial 676 oocytes from 59 patients in their 2nd or third treatment cycle, age <38 years and ≥ 8 oocytes retrieved were cultured in the time-lapse incubator or in a conventional incubator. The primary outcome was proportion of 4-cell embryos on day 2. Secondary outcomes were proportion of 7-8 cell embryos on day 3 and proportion of blastocysts on day 5. Implantation pregnancy rates were registered based on presence of fetal heart activity visualized by ultrasound 8 weeks after embryo transfer.
  
  
  RESULTS
  No significant difference was found between the time-lapse incubator (TLI) and conventional incubator (COI) in proportion of 4-cell embryos on day 2 irrespective of whether data was analyzed according to ITT (RR(TLI/COI): 0.81 (0.65; 1.02)) or PP (RR(TLI/COI): 0.80 (0.63; 1.01)). Nor were any significant differences detected in the secondary endpoints; i.e. proportion of 7-8-cell embryos on day three ITT (RR(TLI/COI): 0.96 (0.73; 1.26)); PP (RR(TLI/COI): 0.95 (0.72; 1.26)) and proportion of blastocysts on day five ITT (RR(TLI/COI): 1.09 (0.84; 1.41)); PP (RR(TLI/COI): 1.09 (0.83: 1.41)). We found no differences in clinical pregnancy rate or implantation rate.
  
  
  CONCLUSIONS
  Culture in the time-lapse incubator supports embryonic development equally to a conventional incubator.
authors.affiliation: The Fertility Clinic, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark. Kirstine.kirkegaard@ki.au.dk
authors.forename: Kirstine
authors.initials: K
authors.lastname: Kirkegaard
authors.forename: Johnny Juhl
authors.initials: JJ
authors.lastname: Hindkjaer
authors.forename: Marie Louise
authors.initials: ML
authors.lastname: Grøndahl
authors.forename: Ulrik Schiøler
authors.initials: US
authors.lastname: Kesmodel
authors.forename: Hans Jakob
authors.initials: HJ
authors.lastname: Ingerslev
mesh_terms: D000328:Adult; D046149:Embryo Culture Techniques / Q000295:instrumentation*; D010064:Embryo Implantation; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007185:Incubators; D009865:Oocytes / Q000502:physiology; D011247:Pregnancy; D018873:Pregnancy Rate