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Egg donation
Each IVF program consists of several stages. One of them is culturing embryos to the blastocyst stage for subsequent transfer into the uterine cavity or freezing. Embryos are cultured in special incubators, which are divided into "benchtop” incubators and incubators with a built-in Time-Lapse system.
Essentially, the latter include a special microscope that is installed inside the incubator. It photographs and saves images at regular short intervals. Each embryo is photographed from the moment of fertilization and throughout the entire incubation period.
Thus, a recording becomes available, showing the development of the embryo to the blastocyst stage. These snapshots can be carefully checked, paused at necessary moments and further decisions can be made by the specialist of the embryology lab.
Embryo cultivation in "benchtop" incubators
The embryologist takes the dishes with embryos out of the incubator daily during the entire cultivation period. This is necessary not only for additional manipulations (for example, hatching of embryos), but also for the monitoring and evaluation of the stage of embryo development, its morphological parameters. Frequent extraction of embryos from the incubator leads to some stress for the embryos, because the gas content, air humidity, and temperature change when they are taken out.
Embryo cultivation in incubators with a built-in Time-Lapse system
Thanks to the Time-Lapse system, there is no need to constantly extract embryos. Specialists take them out of the incubator only if additional manipulations are necessary (for example, hatching, trophectoderm biopsy, etc.). The rest of the time, the embryos remain in stable conditions. The built-in camera photographs them on a regular basis, saves images and creates a video of their development. An embryologist views these files, evaluates and selects the most promising embryos for transfer and vitrification.
It is not an additional service, but a quality standard available to every patient of the clinic.
In protocols without PGT-A of embryos, the embryologist makes a decision on transferring or vitrifying a particular embryo based on the assessment of its morphological parameters. The specialist makes the assessment independently, focusing on the international classification of David Gardner. The morphological parameters of the embryo include:
- The degree of expansion of the blastocyst cavity
- The development stage of the intracellular mass
- The expression of trophectoderm cells
Traditional assessment is quite subjective and does not allow obtaining a complete history of the embryo's development.
Using the traditional assessment, it is possible to overlook pathological embryo cleavage, when the embryo divides directly from 1 to 3 cells, and not in the proper way: from 1 to 2, 4, 8 cells.
Traditional assessment misses more than 70% of embryos with an abnormal number of nuclei, which subsequently leads to a decrease in the implantation rate.
STATISTICS
Compared to traditional cultivation, the use of embryo culture incubators with the Time-Lapse system significantly increases the rate of healthily developing clinical pregnancy and live birth rate, and also significantly reduces the number of miscarriages occurring in the early term. The presented graph shows the results of five clinical studies. Not every clinic will tell you about these findings.
