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The Motivation Behind the Review
As the field of assisted reproductive technology (ART) rapidly evolves, we often see major technological advances implemented in clinics—sometimes in parallel, rarely in concert. When Professor Alison Campbell approached me to co-author this paper, her vision was clear: to bring together the dispersed evidence on the combined use—and potential synergy—of two of the most significant advancements in embryo assessment: time-lapse imaging (TLI) incubators and preimplantation genetic testing for aneuploidy (PGT-A).
Despite individual benefits of each technology, no comprehensive review had yet summarized how their integration could optimize both laboratory workflow and clinical outcomes. By bringing together numerous studies and expert perspectives, our aim was to provide clarity, highlight best practices, and ultimately support clinical teams and patients in making the most informed decisions possible.
Key Findings: Summary of Benefits
Our review identified several advantages to the combined use of TLI and PGT-A in IVF clinics:
| Aspect | How TLI + PGT-A Creates Synergy |
|---|---|
| Fertilisation Assessment | Continuous monitoring improves detection of pronuclear (2PN) formation, enhancing fertilisation assessment accuracy, and defining clear clinical strategies for embryos classified as abnormally fertilised. |
| Workflow Optimisation | Flexible scheduling for procedures; TLI supports earlier insemination of oocytes, allowing complicated procedures to be completed within normal working hours, keeping flexible fertilization assessment and potentially resulting in earlier biopsy and vitrification at optimal times, allowing more efficient lab operations. |
| Biopsy Precision | Identifies precise blastocyst readiness and avoids excluded cells for optimal biopsy of trophectoderm cells and improved accuracy of genetic testing results. |
| Prioritising Embryos | Validated morphokinetic algorithms and AI tools help rank embryos for biopsy based on their likelihood of euploidy, and/or transfer by their implantation/live birth potential among euploids. |
| Post-Warming Assessment | Tracks blastocyst re-expansion after warming, supporting better decisions on embryo transfer. |
| Patient Counselling | Provides predictive insights to help guide patient expectations and treatment decisions. |
| Research & Knowledge | Enables deep ongoing study of embryo dynamics, improving future protocols and understanding. |
In Summary
By integrating time-lapse imaging and PGT-A, clinics can benefit from continuous, undisturbed, non-invasive observation and robust genetic assessment, leading to:
- Improved embryo selection and prioritisation for both biopsy and transfer.
- More flexible and efficient laboratory workflows.
- Better support for single embryo transfer strategies, reducing the risks of multiple pregnancies and potentially shortening time to healthy pregnancy.
- Enhanced patient counselling and expectation setting.
These synergies offer real promise for further improving IVF success rates, while also propelling our knowledge and capabilities forward as a community.
Access the full paper here: Synergies Between Time-Lapse Imaging and PGT to Optimise Laboratory Workflow and Clinical Outcomes - ScienceDirect
Don’t miss our upcoming webinar:
From pronuclear assessment to ploidy: Time-Lapse, 2.1PNs and the clinical importance of embryo classification
Date: Thursday, October 8th
Time: 10 AM (ET) 4 PM (CET)
Topics: Time-lapse, genetic testing