Overview
One of the most important laboratory decisions after fertilisation is to determine which embryo is most suitable for transfer or freezing. Embryologists carefully monitor how embryos develop over the next few days using an embryoscope to make this decision. It’s a specialised incubator that creates a detailed time-lapse record of embryo development. Embryologists can gain additional information during assessment and regularly monitor embryos without removing them from their carefully controlled environment. Though it’s an advanced tool used in laboratories, it’s important to understand its role, benefits, and limitations before deciding whether it should be included in your treatment plan.
Table of Contents
Introduction
After fertilisation, the next few days are among the most important stages of an in vitro fertilisation (IVF) cycle. During this phase, embryologists closely monitor the development of embryos before deciding which one to freeze or transfer. An embryoscope is an advanced incubator used in laboratories that uses time-lapse imaging to record embryo development continuously. This reduces the need for repeated handling and keeps embryos in a stable culture environment. With an embryoscope, embryologists can get a more detailed view of early embryo development than traditional monitoring alone. While it’s an advanced technology that can help embryologists gain additional information during embryo assessment, current research does not show that it improves pregnancy or live birth rates for every patient.
In this post, we’ll discuss how an embryoscope works, what it monitors, its benefits, success rates, and more.
What Is an Embryoscope?
An embryoscope is an advanced IVF incubator used in laboratories that comes with a built-in camera and microscope. With its time-lapse imaging technology, embryologists can monitor embryo development continuously. From fertilisation to the blastocyst stage, an embryoscope creates a continuous visual record of embryo development. This gives embryologists the additional information they may need to assess embryos, along with using conventional grading methods to determine an embryo’s developmental competence and implantation potential.
Understanding Embryoscope Technology
An embryoscope combines 3 functions in one tool, including:
- A built-in microscope to observe embryos during the development phase
- An incubator that maintains optimal conditions for embryo culture
- An automated camera that captures images of embryos every 10-20 minutes, which are compiled into a time-lapse video
Embryologists can use this video to review each stage of the embryo development process in sequence.
How Is It Different from a Conventional IVF Incubator?
The main difference between an embryoscope and a standard IVF incubator is how embryos are monitored. In conventional incubators, embryos are examined at scheduled intervals. On the other hand, an embryoscope provides a complete timeline of embryo development, instead of a few individual observations, by recording their development continuously throughout the culture period.
How Does an Embryoscope Work?
Once fertilisation is complete, embryos are placed inside the embryoscope, where they are cultured and monitored for the next five to six days. During this period, it automatically records embryo development and creates a time-lapse video, which embryologists can review. Here’s the complete process:
Fertilisation and Embryo Culture
Fertilisation takes place either using standard IVF or intracytoplasmic sperm injection (ICSI) after egg retrieval is done. The resulting embryos are then placed inside individual culture wells inside an embryoscope. Here, they develop until the blastocyst stage under controlled laboratory conditions.
Continuous Time-Lapse Imaging
The built-in camera captures thousands of images of each embryo every 10-20 minutes from multiple focal planes. These images that record embryo development from day 1 to day 5 or 6 are compiled into a time-lapse video for reviewing.
Monitoring Embryo Development
Embryologists review this time-lapse video, observing developmental changes that may occur between routine assessments. Before they can move on to the next stage of evaluation, they assess factors like the shape of the embryo, cell division timing, blastocyst formation , and overall developmental progression.
Embryo Selection for Transfer
Embryologists select embryos for freezing or transferring after comparing the information captured by the embryoscope with what conventional embryo grading has provided. They may also analyse your clinical history.
What Does an Embryoscope Monitor?
An embryoscope records different aspects of embryo development that complement the information provided by standard embryo evaluations. Embryologists can get a complete picture of embryo development by monitoring the parameters given below.
Parameter monitored | What it shows |
Cell division timing, also known as morphokinetics | It records exactly when the embryo divides from one cell to two, four, eight cells, and more. The timings of these divisions can provide additional information about embryo development, but it can’t be used on its own to select an embryo for transfer. |
Embryo morphology or shape | It assesses the appearance of the embryo, including symmetry, cell number, fragmentation, and other visible features used during routine embryo grading. |
Developmental milestones | It helps the embryologist track key changes like fertilisation, cleavage, blastocyst formation, morula formation, expansion, and hatching. With information like this, embryologists can understand how embryo development is progressing from day 1 to day 5 or 6. |
Blastocyst formation | This monitors whether the embryo reaches the blastocyst stage and how it develops during expansion. It’s an important milestone because embryos are usually frozen or transferred during the blastocyst phase. |
Development patterns | This detects developmental changes in the embryo. These include direct and reverse cleavage, any unusual or irregular division patterns, and multinucleation. Time-lapse imaging can help embryologists identify changes that may go unnoticed during routine embryo assessment |
Benefits of Using an Embryoscope in IVF
Here are the many benefits of using an Embryoscope during IVF:
Offers a complete timeline of embryo development
An embryoscope captures images of the embryo throughout the embryo culture compared to conventional monitoring, which records embryo development only at scheduled intervals. These images are compiled into a time-lapse video, which embryologists can review to check the sequence of embryo development. They can also review changes that may occur between routine observations.
Helps identify unusual patterns
Time-lapse imaging can help embryologists assess how the embryo develops over time by reviewing the timing and sequence of cell divisions. This can help them identify any irregular patterns that may not be visible during periodic assessment.
Provides additional information for embryo assessment
Embryologists usually evaluate the information recorded by an embryoscope, along with conventional embryo grading records. This can support embryo assessment, but this does not mean that the clinical judgment and expertise of the embryologist can be replaced.
Supports undisturbed embryo culture
Embryos aren’t removed from the incubator for routine monitoring. The images are captured with built-in cameras from inside the incubator, which helps maintain a stable culture environment throughout the development phase.
Does an Embryoscope Improve IVF Success Rates?
An Embryoscope can improve the amount and quality of information available during embryo assessment, but current research does not show that it improves IVF success rates compared to conventional embryo monitoring.
Some earlier studies suggested that continuously monitoring embryos and assessing its morphokinetic can help identify the ones with better potential for development and implantation, but more recent, high-quality studies have shown mixed results.
One of the largest studies conducted on time-lapse imaging trials (TILT) for embryo monitoring in IVF was published in The Lancet in 2024. This study revealed that a time-lapse imaging system for monitoring embryo development did not significantly improve live birth rates compared with conventional embryo incubation and assessment.
Another Cochrane systematic review found that there is not enough high-quality evidence to show that a time-lapse imaging system improves ongoing pregnancy, live birth, or clinical pregnancy rates compared with conventional embryo monitoring. Researchers noted that this technology can provide additional information about embryo development, but more research is needed into whether it improves IVF treatment outcomes.
This does not mean that Embryoscope plays no role in IVF. It’s an important laboratory tool that can support your doctor in assessing embryo growth. However, it’s important to remember that no single technology can guarantee pregnancy, and IVF success can depend on several factors, including overall reproductive health of both partners, underlying cause of infertility, maternal age, egg and sperm quality, embryo health, uterine conditions, and more.
Who May Benefit from Embryoscope Technology?
Your fertility specialist may consider using an embryoscope if:
- Several embryos are present, and they need additional information to select the one for transferring and freezing.
- You’ve had previous unsuccessful IVF attempts, and they need a more detailed record of embryo development.
- Preimplantation genetic testing (PGT) is a part of your IVF treatment, as embryos are cultured until the blastocyst stage before they are tested, and embryologists may have to monitor their development throughout this process.
- Time-lapse monitoring is a part of the laboratory’s protocol for routine embryo assessment.
Embryoscope vs Conventional Embryo Monitoring
The table below highlights the key differences between embryoscope and conventional embryo monitoring.
Feature | Conventional embryo monitoring | Embryoscope |
Embryo assessment | Embryos are assessed at specific points of time during culture | Embryos are continuously monitored using time-lapse monitoring during the culture period |
Embryo handling | Embryos have to be briefly removed from the incubator for microscopic examination | It reduces the need for embryo handling as embryos remain inside the incubator, while their images are captured automatically with a built-in camera |
Developmental record | Individual observations at scheduled intervals form the basis of the assessment | Thousands of images taken of the embryo development, from fertilization to the blastocyst stage, are compiled into a time-lapse video for reviewing |
Information available | This helps embryologists assess embryo morphology, such as cell number, fragmentation, and symmetry, at each observation. | In addition to the information provided by conventional embryo monitoring, embryologists can use an embryoscope to review the time and sequence of developmental changes throughout embryo development. |
Embryo selection | Embryologists select the embryo based on conventional morphological grading and clinical judgement. | Embryologists use their expertise and clinical judgement, combining information from conventional embryo assessment with time-lapse monitoring records to select the embryo. |
Conclusion
Learning more about an embryoscope can help you get a better picture of what happens behind the scenes in the laboratory. With this advanced, time-lapse imaging tool, your fertility specialist can continuously monitor and have a detailed record of embryo development without disturbing them. It’s an important laboratory tool that supports embryo assessment, along with data from conventional embryo monitoring, but current research does not prove that Embryoscope can improve IVF success, pregnancy, or live birth rates. Your fertility specialist may recommend including it in your IVF treatment only if necessary based on your individual circumstances.