Time lapse technology / morphokinetics in Embryology
Reading all the literature and references I come to a conclusion that , the end point of any Time lapse technology in embryo culture is getting a blastocyst, or blastocyst is the end point if any Time lapse technology , may be it Embryoscope or something else.
As we are doing 100 % blastocyst transfer since 8/9 years , if we get a day 5/6 blastocyst for particular couple, then it is obvious that this embryo is competent enough to reach that stage. It is survival of the fittest.
The problem occurs when the centre transfer day 2/3 embryos. There may be multiple embryos on day 2/3, but which is going to survive ,very difficult to assess. All may look similar, but when they are put to the challenge to make their own food and survive onwards without maternal support ( called embryonic genome activation), then many of them wither. As they look similar, the clinician “may” transfer the withering one. Here, the Time Lapse technology helps to select the best one ,which “may” survive. But looking at the high cost of Time lapse, I feel blastocyst culture is easy and quite cheaper, and top of that, we are transferring the end point .
” The Mother Nature also selects best quality day 5 embryo.”
If we don’t get the blastocyst, then this cohort of embryo are genetically poor or aneuploid, and even though they are good at day2/3 ( in Time Lapse/ or regular incubator, ) they are not going to survive. The patient may see the embryo transfer occurred , but it fails. So when we don’t get any blastocyst on day 5, we defer it and tell the couple about the event ( Not a very easy task for any IVF clinic)