3. Results 13 papers Heterogeneity of morphokinetic and conditions (culture media, mode of fertilization, day of ET)

5. Results Only one study demonstrated significantly improved clinical pregnancy rates when embryos were selected by TLM in addition to conventional morphology

6. Conclusion While TLM has the potential to revolutionize clinical embryology, there are currently no high-quality data to support the clinical use of this technology for selection of human preimplantation embryos.

7. Conclusions reliable prediction of blastocyst conversion based on early morphokinetic markers may be the main advantage of TLM. Surprisingly few data, however, indicate whether TLM effectively distinguishes between embryos with high and low implantation potential

8. Conclusions Our intent in writing this review is not to discourage further research regarding the clinical utility of TLM for embryo selection, but rather, quite the opposite: we hope to cast light on unresolved questions and inconsistencies in current nomenclature in order to motivate future appropriately designed studies

9. Time-lapse embryo imaging for improving reproductive outcomes: a systematic review and meta-analysis US Obstet Gynecol 2014 we only included RCTs comparing time-lapse embryo imaging versus standard embryo monitoring

10. Results 2 RCT were included A total of 138 women : 68 were allocated for time- lapse monitoring system and 70 were allocated for conventional incubation ( EmbryoScope, Primo Vision time- lapse system)

11. Results Clinical pregnancy: The pooled estimate was not sufficiently precise to identify whether TLM causes a small benefit, no effect or small harm: RR 1.05, 95% CI 0.80 to 1.38, P = 0.73

13. There is no evidence from RCTs about the effect of TLM on live birth. The current evidence from available RCTs shows that TLM does not cause a large change on the chance of achieving clinical and/or ongoing pregnancy when transferring blastocyst stage embryos

14. Future directions An ideal study- measure implantation rates among patients randomized to SET following: a) embryo culture in a TLM with selection based on conventional morphology alone b) embryo culture in a TLM with selection based on morphokinetic parameters plus conventional morphology

15. the ESHRE stated that the aim of IVF treatments is the birth of a single neonate, while a multiple pregnancy is considered a complication of IVF treatment

16. eSET (BLT)

17. Results Meir 10 mon. of embryoscope 161 cycles. 3 did not reach ET 74 SET, 39 eSET 45 DET

18. p-ValueDouble-Embryo transfer (n=45) Elective Single – embryo transfer (n=39) 0.00633.6±5.730.5±4.8Age (years) 0.7623.9± 3.7423.5 ± 5.6Body mass index(Kg/m²) 0.370.8± 0.61.0 ±0.9Gravidity 0.060.5± 0.60.8±0.8Parity 0.062.8± 1.92.1± 1.6 Previous IVF cycles 0.652.7± 2.92.4 ±1.5Duration of infertility (years) 0.77.0± 3.66.7± 2.9Basal FSH (IU/ml)

19. p-ValueDouble-Embryo transfer (n=45) Elective Single – embryo transfer (n=39) 0.241683± 11571966 ± 1003 E 2 level HCG (pg/ml) 0.610.6± 0.40.7± 0.5 Progesterone at HCG (ng/ml) 0.110.6± 4.412.3± 5.0No. of oocytes retrieved 0.7754.7± 20.453.6± 15.9Fertilization rate (%) 0.623.0± 1.53.2± 1.7Available embryos for ET 0.603.4± 0.63.3± 0.9Embryo grading

20. p-ValueDouble-Embryo transfer (n=45) Elective Single – embryo transfer (n=39) 0.846.6%51.3%Chemical pregnancy 0.940.0%43.6%Clinical pregnancy 0.0527.8%0%Multiple pregnancy

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