Purpose: Several time-lapse imaging (TLI) systems for non-invasive continuous monitoring of developing embryos are currently available. The present study explored the prevalence, means of acquisition, and clinical application of TLI systems in USA in vitro fertilization (IVF) laboratories.
Methods: An online cross-sectional survey of 294 USA IVF laboratory directors was conducted in February and March 2016. Those directing more than one laboratory were asked to complete the survey for their home program and for their smallest laboratory by number of IVF/intracytoplasmic sperm injection (ICSI) cycle starts. Use of TLI was analyzed using logistic regression to calculate odds ratios (OR).
Results: Of 294 directors surveyed, 162 (55%) reported data on 204 laboratories. Thirty-five laboratories (17%) possessed at least one TLI system (median 2, interquartile range 1-4, total range 1-11). The more oocyte retrievals a laboratory performed annually, the more likely the laboratory was to possess a TLI system. Fifteen laboratories (43%) purchased their own systems, while others leased, loaned, or received donated systems. Twenty-five laboratories (71%) reported using TLI for embryo selection; all used TLI always, or usually, in combination with standard morphology evaluation. Twenty laboratories (80%) offered TLI to all patients. Some laboratories charged patients for TLI. Directors with TLI systems were more inclined to believe that TLI has value for embryo selection in clinical IVF.
Conclusions: TLI system possession in USA IVF laboratories is low, although positively associated with the number of retrievals performed and with directors' opinions on the technology's utility. Over 70% of laboratories with TLI systems use them clinically, and less than half purchased their systems.
Keywords: Assisted reproductive technology; Embryo selection; Morphokinetics; Time-lapse imaging.