Is time-lapse imaging right for me? Dr Dean Morbeck

17 November 2016

Is time-lapse imaging right for me? Dr Dean Morbeck

Did you see our story on time-lapse imaging of embryos and wonder if it could help you with your journey to parenthood?  You’re not alone!

Time-lapse morphometric imaging, what we affectionately refer to as TiMI, is an exciting advance in embryo culture.  TiMI allows embryologists to see all stages of embryo development while simultaneously leaving them undisturbed. 

What are the benefits of TiMI?

More information

Remember learning about mitosis in biology?  You know – that bit where a cell makes a copy of its DNA and then divides into two daughter cells.  Well it turns out that 10-20% of embryos in culture divide from one to three cells! 

The video below shows an embryo that does this. 

 

What’s important to notice is that once the embryo has more than 3 cells, it looks very nice.  In fact, we probably would select it if we were doing a day 3 embryo transfer.  We now know that these embryos have < 1% chance of implanting. 

Less handling

Every time an embryologist removes a dish from an incubator, the pH and temperature of the media change slightly.  The longer the dish stays out, the longer it takes to recover.  Embryos use energy to adjust to these changing conditions. 

During the first 3 days of culture, embryos are quietly going about reprogramming and getting ready for their next big step – becoming a blastocyst.  We know that not all embryos are equal in their ability to make it through this phase and some may not have the capacity to both respond to pH and temperature changes and develop to blastocysts.

This picture shows an EmbryoScope – one of the two types of TiMI systems used at Fertility Associates.  It consists of an incubator, microscope, camera and computer, so everything is in one place and embryos do not have to be removed to see how they’re doing.  

Better selection

In addition to choosing against abnormally dividing embryos, there are many other indicators of implantation potential.  We use a scoring system that incorporates key steps to provide a ranking of embryos.  If you are fortunate to have several embryos to choose from, the added information from time-lapse lets us rank the embryos so we have a more informed choice when choosing which embryo to transfer, whether it’s a fresh or frozen embryo transfer. 

Bonus: your baby’s first video!

Clearly no one is going to go through IVF just to have a video of their child before implantation.  A video is nice, but if you’re going to go the extra mile and use TiMI, you are doing so to improve your chance of having a baby.  But since you’ve taken the extra step, a video for baby’s album is a nice add-on!

Every Journey is Unique                  
  • Whether TiMI is right for you depends a bit on your own fertility story. This uniqueness only grows as you go through IVF, where the number of eggs, how well they fertilize and how they grow is as individual as how you got to this point.  Your first, or next, IVF story is unwritten and difficult to predict.
  • The following are some groups who should benefit the most from TiMI: 
    • History of poor embryo development. First, less handling in TiMI may lead to better embryo development.  We’ll also have a better idea of what goes wrong when development is poor and if we need to transfer early, have a better idea of which to choose.
    • Few embryos. With TiMI, we can often pick the best embryo by day 3.  So if you know you’ll make few eggs or have few embryos for selection, the combination of a day 3 transfer with TiMI-based selection gives you an added level of assurance that we’re picking the best embryo. 
  • Who doesn’t benefit from TiMI?
    • We believe nearly all patients benefit from TiMI because it reduces handling of embryos and gives more information. While some benefit from less handling alone, most patient’s embryos are robust and not adversely affected by our routine handling process.  Unfortunately we have no way of predicting who will benefit.
    • If you are young and make a lot of eggs, odds are that you’ll have a lot of blastocysts. While some embryos benefit from less handling, most patient’s embryos are robust and not adversely affected by our routine handling process. 

 Dr Dean Morbeck is Fertility Associates Science Director.