A cautionary note against embryo aneuploidy risk assessment using time-lapse imaging

Abstract

Preimplantation genetic screening (PGS) for embryo aneuploidy using embryo biopsy is a widely available technique used to select embryos for transfer following IVF for certain patient populations. Since its introduction, there has been an ongoing search for a non-invasive technique to perform PGS. Such an advance would revolutionize the field of IVF enabling PGS to be used universally as a routine embryo selection tool with the potential to significantly increase pregnancy rates and decrease poor outcomes such as miscarriage. Recent publications illustrating the development of an algorithm using time-lapse imaging of IVF embryos have claimed to have done just this. We believe that the statements made in these articles, which include the proposed ability to increase pregnancy rates by determining embryo aneuploidy risk by time-lapse imaging, are premature and to this point unsubstantiated by the published data. We provide evidence from existing publications and from our own data that suggests that the statements recently made are misleading. We make the point that further investigation is needed either in the form of a larger, age-adjusted data set or preferably in a randomized controlled trial.

Keywords: aneuploidy; blastocyst; embryo implantation; morphokinetics; preimplantation genetic screening; time-lapse imaging.