title: Improved implantation rates of day 3 embryo transfers with the use of an automated time-lapse-enabled test to aid in embryo selection.
abstract: OBJECTIVE
  To determine if an automated time-lapse test (TL-test) combined with traditional morphology for embryo selection and day 3 transfer results in improved clinical outcomes.
  
  
  METHODS
  Prospective concurrent-controlled pilot study.
  
  
  METHODS
  IVF clinic and laboratory.
  
  
  METHODS
  A total of 319 female patients <41 years old, with day 3 embryo transfer, fewer than three failed IVF cycles, and at least four zygotes (2-pronuclear) on day 1.
  
  
  METHODS
  Automated time-lapse embryo assessment combined with morphologic assessment in the study (test) group compared with morphologic assessment only (control group).
  
  
  METHODS
  Embryo implantation, pregnancy, and multiple pregnancy rates. Subanalysis of implantation potential of embryos based on the TL-test (TL-high vs. TL-low) scores.
  
  
  RESULTS
  Implantation and clinical pregnancy rates were significantly higher in the test group compared with the control group (implantation rates 30.2% vs. 19.0%, clinical pregnancy rates 46.0% vs. 32.1%, respectively). Multiple pregnancy rates were not statistically different (26.7% vs. 18.3%). Test group patients receiving at least one TL-high embryo had significantly higher implantation rates than patients receiving only TL-low embryos (36.8% vs. 20.6%). TL-high compared with TL-low embryos had significantly higher implantation rates (44.7% vs. 20.5%). Among morphologically good embryos, TL-high embryos were more likely to implant than TL-low embryos (44.1% vs. 20.6%).
  
  
  CONCLUSIONS
  This is the first report demonstrating improved implantation rates in patients receiving day 3 embryo transfers based on the combined use of a TL-test along and traditional morphology. Our findings confirm that the noninvasive TL-test adds valuable information to traditional morphologic grading.
  
  
  BACKGROUND
  NCT01671657.
authors.affiliation: Palo Alto Medical Foundation Fertility Physicians of Northern California, San Jose, California.
authors.forename: G David
authors.initials: GD
authors.lastname: Adamson
authors.affiliation: Palo Alto Medical Foundation Fertility Physicians of Northern California, San Jose, California.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Abusief
authors.affiliation: Palo Alto Medical Foundation Fertility Physicians of Northern California, San Jose, California.
authors.forename: Lourella
authors.initials: L
authors.lastname: Palao
authors.affiliation: Palo Alto Medical Foundation Fertility Physicians of Northern California, San Jose, California.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Witmer
authors.affiliation: Palo Alto Medical Foundation Fertility Physicians of Northern California, San Jose, California.
authors.forename: Lonyl M
authors.initials: LM
authors.lastname: Palao
authors.affiliation: Palo Alto Medical Foundation Fertility Physicians of Northern California, San Jose, California. Electronic address: gvakhaa@pamf.org.
authors.forename: Marina
authors.initials: M
authors.lastname: Gvakharia
mesh_terms: D000328:Adult; D001331:Automation; D001755:Blastocyst / Q000502:physiology*; D002140:California; D046149:Embryo Culture Techniques; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D009024:Morphogenesis; D010865:Pilot Projects; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple; D011446:Prospective Studies; D013997:Time Factors; D059008:Time-Lapse Imaging / Q000379:methods*; D016896:Treatment Outcome
keywords: Embryo selection; automated; morphology; prognostic test; time-lapse