What Is EmbryoScope? – Use in IVF

By MD, PhD, MSc (gynecologist), BSc, MSc, PhD (senior clinical embryologist), (embryologist), BSc, MSc (embryologist) and (invitra staff).
Last Update: 03/24/2020

The Embryoscope is a state-of-the-art incubator that allows for the uninterrupted viewing of embryos in real time. This incubator consists of a camera capable of capturing images every 10 minutes during the entire embryonic development of those embryos cultivated in vitro, and thus it is used for in vitro fertilization or egg donation treatments.

This novel incubation technology makes it possible to observe changes in the embryos, which would go unnoticed if a conventional incubator were used. Therefore, the Embryoscope offers more information, which is a great advantage in embryo selection.

What is Embryoscope?

The Embryoscope is a innovative incubator that incorporates time-lapse technology. This means that inside the incubator there is a camera that takes images of the embryos every 10 minutes, so that from the outside you can see a video of the embryonic development.

Other incubators with time-lapse technology include Geri®, Miri®, CCM (Cell Culture Monitoring System), Primo Vision™ or Eeva™.

This innovative incubator allows both biologists and future parents to observe the first hours of the future baby's life. What’s more, the embryo is developed without the need to be manipulated and taken outside for observation.

Benefits

What really makes the Embryoscope incubator revolutionary within assisted reproduction is the incorporation of a camera that automatically takes images every 10-15 minutes.

Conventional incubators do not have a camera, so in order to observe the embryos they must be removed from the incubator. This type of incubator allows evaluations to be carried out at specific times, missing what happens between one observation and the next. Furthermore, it is not advisable to carry out many evaluations, as there are numerous studies that indicate that continuously removing embryos from the incubator can compromise their viability.

The following are the main advantages of the Embryoscope:

  • The embryos do not have to be removed for evaluation, which reduces the manipulation of the embryos.
  • More stable culture conditions. This avoids changes in temperature, light, pH, etc. that can cause stress and affect embryonic quality.
  • It allows us to see in real time what is happening at each moment, ensuring that we can choose the embryos with the greatest potential for implantation for transfer to the mother's uterus.
  • It provides a greater amount of information.

Embryologist José Muñoz he explains the advantages of this type of incubator:

For example, we are seeing the appearance of two-cell stage multinucleation which in four cells disappears and therefore earlier or with a normal incubator today could not be seen.

Limitations

The Embryoscope, in spite of all its advantages, also has some limitations that are discussed below:

  • Inability to rotate the embryos during observation, taking into account that they are three-dimensional structures.
  • Bubbles appear in the culture medium. This can lead to the loss of some event during the development of the embryos.
  • There is a small gap, since all the eggs are not injected at the same time. However, this gap is so minimal that it does not affect the results.
  • Higher cost of embryo culture and higher cost of IVF treatments.

Embryo culture with Embryoscope

After the extraction of the eggs and their fertilization with the sperm in the laboratory, the embryos generated will be deposited in the incubator for 3-5 days. During this time, the embryos must develop by increasing their number of cells day by day.

The embryos remain in culture plates that have all the necessary nutrients for their development. In addition, the incubators maintain low oxygen pressures to mimic the conditions of the fallopian tube, which is where the embryo would be found in a natural gestation during these early days.

When the 3rd or 5th day of embryonic development comes, the best selected embryo is transferred or frozen for future attempts.

Embryo Selection

Until relatively recently, the only method of embryo sorting consisted of evaluating the morphological characteristics of the embryos under the inverted microscope. In this way, parameters such as cell size and symmetry, cell number, percentage of cell fragmentation, etc. are analysed.

The Embryoscope and its Time-Lapse technology allows the observation of the embryos from the moment of fertilization until they are transferred to the uterus. This ensures that more information is obtained and that embryo selection is made on the basis of morphokinetic characteristics.

Therefore, the general conditions to be taken into account are the following:

  • The embryos must develop at an adequate speed.
  • The correct embryonic morphological changes must occur according to the stage.

There are a number of moments in the development when the fulfilment of these conditions is most relevant. Among them is the time between fertilization and first division.

If you want more information about the criteria for classification of embryos, you can visit the following article: Classification of the embryos according to their quality.

Who needs Embryoscope?

The use of this technology is indicated for all types of patients receiving assisted reproduction treatment in which the embryos need to be cultivated in the laboratory, such as in vitro fertilization or egg donation.

However, the patients who can benefit most are those who have a large number of embryos, since it can be more complicated to determine among them which ones are optimal for transfer.

It is also advisable to use it in couples who have had several failed in vitro fertilization cycles. Specialist José Muñoz tells us that:

In principle, we are using it in patients with good embryonic quality and who do not achieve pregnancies, to see more, learn more and choose better the embryos that are transferred.

FAQs from users

Does the Embryoscope improve success rates?

By Blanca Paraíso MD, PhD, MSc (gynecologist).

There's quite a bit of controversy about that. In general, there is no clear evidence that time-lapse incubators improve success rates. However, there are studies that claim that more embryos will be able to reach the blastocyst stage due to better culture conditions and that higher gestation rates can be achieved by better embryo selection.

What other types of incubators are available for embryo culture?

By Blanca Paraíso MD, PhD, MSc (gynecologist).

The first incubators for embryo culture were large and the embryos of all patients were stored in the same space. Therefore, when a patient's embryos had to be removed for microscopic viewing or transfer, the temperature and gas conditions were temporarily altered, and this could affect all the embryos.

More recently, "benchtop" or "sandwich" type incubators have been developed. These have individualized compartments for each patient, so that opening one does not affect the others. In addition, the culture conditions are much better than with the first incubators, as they work at low oxygen pressures, so they imitate the conditions of the human body much better. The difference between these incubators and the Embryoscope® or other types of time-lapse incubators is that they do not have a built-in camera, so if you want to monitor the development of the embryos you need to remove them from the incubator to look at them under the microscope.

What has changed in embryo selection with the incorporation of Embryoscope?

By Marta Barranquero Gómez (embryologist).

With conventional incubators, embryo selection is based on morphological criteria. To do this, the embryos must be taken out of the incubator and observed under the microscope. This whole process could alter the culture conditions, no matter how fast it is done.

However, the Embryoscope allows the analysis of the embryo kinetics. Furthermore, an evaluation can be made at any time during development, without having to remove the embryos from the incubator and, therefore, without altering the culture conditions.

How much does the embryoscope incubator cost when used in IVF?

By Marta Barranquero Gómez (embryologist).

Prices for embryo culture in Embryoscope type incubators may vary from clinic to clinic. However, the added cost of conventional IVF is usually around 300-500 euros.

Suggested for you

If you would like more information on time-lapse technology, you can visit the following article: What is time-lapse - Improving in vitro embryo development.

On the other hand, the objective of this incubator is to transfer the best embryo, so I recommend you read the following article: Embryo transfer.

Our editors have made great efforts to create this content for you. By sharing this post, you are helping us to keep ourselves motivated to work even harder.

References

Authors and contributors

 Blanca Paraíso
Blanca Paraíso
MD, PhD, MSc
Gynecologist
Bachelor's Degree in Medicine and Ph.D from the Complutense University of Madrid (UCM). Postgraduate Course in Statistics of Health Sciences. Doctor specialized in Obstetrics & Gynecology, and Assisted Procreation. More information about Blanca Paraíso
License: 454505579
 José Muñoz Ramírez
José Muñoz Ramírez
BSc, MSc, PhD
Senior Clinical Embryologist
Bachelor's Degree in Biology from the University of Malaga. Master's Degree in Genetics by the University of Alcalá, and Master's Degree in Assisted Reproduction from the University of Valencia. He works as a clinical embryologist at Clínica Tambre (Madrid, Spain), in addition to being an Associate Professor at the University of Murcia. More information about José Muñoz Ramírez
 Marta Barranquero Gómez
Marta Barranquero Gómez
Embryologist
Graduated in Biochemistry and Biomedical Sciences by the University of Valencia (UV) and specialized in Assisted Reproduction by the University of Alcalá de Henares (UAH) in collaboration with Ginefiv and in Clinical Genetics by the University of Alcalá de Henares (UAH). More information about Marta Barranquero Gómez
License: 3316-CV
 Neus Ferrando Gilabert
Neus Ferrando Gilabert
BSc, MSc
Embryologist
Bachelor's Degree in Biology from the University of Valencia (UV). Postgraduate Course in Biotechnology of Human Assisted Reproduction from the Miguel Hernández University of Elche (UMH). Experience managing Embryology and Andrology Labs at Centro Médico Manzanera (Logroño, Spain). More information about Neus Ferrando Gilabert
Adapted into english by:
 Romina Packan
Romina Packan
inviTRA Staff
Editor and translator for the English and German edition of inviTRA. More information about Romina Packan

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