Evaluating time-lapse imaging systems for embryo incubation and selection in ART: a critical review of a randomized controlled trial

Reprod Biomed Online. 2025 Jun;50(6):104937. doi: 10.1016/j.rbmo.2025.104937. Epub 2025 Mar 15.

Abstract

Time-lapse imaging has increasingly been introduced into IVF laboratories over the last decade, with some reported improvements over conventional practices reported in incubation conditions, workflow and embryo assessment and selection, although randomized controlled trials, with heterogeneous methodologies, have not demonstrated its superiority in clinical outcomes. A recent multicentre, three-parallel group, double-blind, randomized controlled trial assigned IVF or intracytoplasmic sperm injection patients in a 1:1:1 ratio to study the clinical effectiveness of time-lapse imaging systems for embryo incubation and selection. It concluded that the use of time-lapse imaging did not significantly increase the odds of live birth compared with standard care without time-lapse imaging. The current authors question the experimental design, methodology and reporting of results within that study and highlight the need for access to supplementary data to allow clinical professionals to analyse objectively and ultimately aim to determine whether this technology may improve the quality of care of their patients.

Keywords: Embryo culture; Embryo selection; IVF; Intracytoplasmic sperm injection; Time-lapse imaging.

Publication types

  • Review

MeSH terms

  • Embryo Culture Techniques
  • Female
  • Fertilization in Vitro* / methods
  • Humans
  • Pregnancy
  • Randomized Controlled Trials as Topic
  • Reproductive Techniques, Assisted*
  • Sperm Injections, Intracytoplasmic
  • Time-Lapse Imaging* / methods