Time-lapse imaging of embryos
A three-arm trial separated the camera from the software. Neither did anything.
Two claims are usually blended when this is sold: that the embryos are never taken out of the incubator so conditions are more stable, and that continuous imaging plus an algorithm picks a better embryo than an embryologist can.
A double-blind randomized trial in 15 Dutch clinics enrolled 1,731 couples into three arms specifically to separate those claims:
| Arm | Cumulative ongoing pregnancy at 12 months |
|---|---|
| Time-lapse plus the selection algorithm | 50.8% (293 of 577) |
| Time-lapse with routine selection by an embryologist | 50.9% (295 of 579) |
| Routine selection, embryos taken out as usual | 49.4% (284 of 575) |
P = 0.85. The spread across all three arms is 1.5 percentage points. Neither the algorithm nor the undisturbed culture made a difference.
The Cochrane review of 9 randomized trials covering 2,955 couples rated the evidence very low to low, and noted that there were no data on cumulative live birth or ongoing pregnancy rate or cumulative clinical pregnancy rate
at all.
on balance, the findings from moderate/high quality evidence shows that this add-on has no effect on the treatment outcome.
Black is not the same as grey. Grey means nobody has looked properly. Black means people looked properly and the answer is no.
The formal cost analysis of the same trial found the laboratory's own extra cost was about €237 per patient for the algorithm version (95% CI −€35 to €508, so the trial could not establish that it cost more at all), with no clinical gain. What patients are charged for it as an add-on is typically far higher.