What is Timelapse Technology?
Timelapse is an exciting new advancement in IVF which allows us to capture a video of an embryo as it develops, when previously all that was possible was seeing a snapshot by looking down the microscope.
It uses a camera built into the incubator to take pictures of the embryo every few minutes for 5 days as it develops. This creates thousands of images which are put together to make a detailed video of the embryo growing from the point of fertilisation through to the blastocyst stage. The videos provide a huge amount of information about the quality and potential of the embryo which can be used to select which one to transfer, to identify embryos that may be abnormal, and to figure out which ones might be suitable for freezing for future use.
Timelapse is the name of the technology but there are many companies which have developed commercial incubators, so you may hear it referred to as names such as EmbryoScope, Primo Vision, early embryo viability assessment (EEVA), CAREmaps, Geri, timelapse incubation (TLI), and morphokinetic monitoring.
The Benefits of Timelapse
The most important benefit of timelapse technology is that it provides the embryologist with so much information about the quality of the embryos. It could be that two embryos look the same, but actually timelapse shows there were subtle differences in the time taken to reach important developmental milestones which may make it more or less likely to produce a pregnancy.
There are also many strange things an embryo can do which affect its quality and these things would be missed without timelapse. For example, sometimes cells can go backwards after they have divided and merge back into one cell. This suggests that the embryo is distressed and is less likely to implant. It can also show if the embryo has fertilised abnormally which could indicate chromosome abnormalities called aneuploidy. These are just a few examples of the ways timelapse can help with embryo selection but there are many features an embryologist looks for in the video. There are even artificial intelligence systems now being developed which use algorithms to choose which embryo is statistically most likely to produce a pregnancy based on timelapse videos.
The second benefit of timelapse is for the happiness of the embaby. When embryos are growing in the lab during the earliest stages of development, they stay in an incubator where the conditions are tightly controlled. They are extremely sensitive to their environment so they must stay incubated until they are ready to be put back into the uterus. With standard, conventional incubation the embryo must be taken out of its incubator to be checked with a microscope. This exposes it to the cold, harsh air of the lab with much higher levels of oxygen and carbon dioxide than in the incubator which can be harmful to development. The check must be done every day for 5 days to monitor the embryo’s progress and every time it gets a little more stressed. Using timelapse technology means that the embryo can stay growing happily in its optimal environment without any disturbances until it is ready to be returned to the uterus.
Should I Pay Extra for Timelapse?
There is often a cost associated with using the advanced incubators as not all clinics include timelapse in the cost of treatment. This can come with a heavy price tag up to £1000 so is it worth the money?
Timelapse is still a relatively new predictive tool. There is still not enough data to say for sure that using timelapse directly increases pregnancy rates, however almost all modern clinics now use timelapse incubators because of the amount of additional information it provides. Timelapse should at least be offered, if not included as standard.
The UK’s IVF regulator – The HFEA, have a traffic light system for add-ons such as timelapse to indicate how effective they are. Timelapse has been given an amber rating which means there is still conflicting evidence and further research is required before it can be officially recommended for use.
Although the extra information from timelapse videos can reveal important information about the embryos, the best use is to de-select embryos which have shown concerning behaviours. Therefore, if you did not have many eggs collected or had poor fertilisation results, it is likely that the only viable embryos will be transferred anyway. This means it is less beneficial to pay extra for timelapse when embryo selection is not a priority. However, it is still useful in ensuring the embryos do not get disturbed during development, as this will give them the best chance of growing to their full potential.