Improved implantation rates of day 3 embryo transfers with the use of an automated time lapse enabled test to aid in embryo selection

An automated noninvasive time-lapse embryo assessment test can be used together with embryo morphology to increase implantation rates after day 3 transfer.

G. David Adamson, M.D., Mary E. Abusief, M.D., Lourella Palao, B.S., Jennifer Witmer, M.S., Lonyl M. Palao, M.S., Marina Gvakharia, M.D., Ph.D.

Volume 105, Issue 2, Pages 369-375


To determine if an automated time-lapse test (TL-test) combined with traditional morphology for embryo selection and day 3 transfer results in improved clinical outcomes.

Prospective concurrent-controlled pilot study.

IVF clinic and laboratory in the United States.

A total of 319 female patients <41 years old, with day 3 embryo transfer, fewer than three failed IVF cycles, and at least four zygotes (2-pronuclear) on day 1. Intervention(s):
Automated time-lapse embryo assessment combined with morphologic assessment in the study (test) group compared with morphologic assessment only (control group).

Main Outcome Measure(s):
Embryo implantation, pregnancy, and multiple pregnancy rates. Subanalysis of implantation potential of embryos based on the TL-test (TL-high vs. TL-low) scores.

Implantation and clinical pregnancy rates were significantly higher in the test group compared with the control group (implantation rates 30.2% vs. 19.0%, clinical pregnancy rates 46.0% vs. 32.1%, respectively). Multiple pregnancy rates were not statistically different (26.7% vs. 18.3%). Test group patients receiving at least one TL-high embryo had significantly higher implantation rates than patients receiving only TL-low embryos (36.8% vs. 20.6%). TL-high compared with TL-low embryos had significantly higher implantation rates (44.7% vs. 20.5%). Among morphologically good embryos, TL-high embryos were more likely to implant than TL-low embryos (44.1% vs. 20.6%).

This is the first report demonstrating improved implantation rates in patients receiving day 3 embryo transfers based on the combined use of a TL-test along and traditional morphology. Our findings confirm that the noninvasive TL-test adds valuable information to traditional morphologic grading.

Clinical Trial Registration Number:

  • Daniel J. Kaser, MD

    Dear Dr. Adamson and colleagues,
    Thank you for this contribution, which demonstrates higher implantation and clinical pregnancy rates for day 3 embryo transfers with selection based on the adjunctive use of time-lapse imaging. Could you please comment further about the selection algorithms applied in the test group? That is, how was the automated Eeva score reconciled with conventional morphology?
    Thanks very much for your comments.

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