Camera technology The selfie that can help me get pregnant Selecting the right embryo to give you back is crucial if you are going to achieve a pregnancy after IVF/ICSI. We know that. Looks aren't everything. An embryo can look good but not have the potential to create a pregnancy.

How can we assess an embryo’s potential ? Time lapse imaging of the growth of each embryo. We examine the embryo growth very carefully for any abnormal growth events that will adversely affect its potential to create a pregnancy. A digital video recording is obtained for each embryo by taking a photograph every 10 mins. There are several systems that are able to do this

MIRI TL from ESCO Bench top incubator combined with a time lapse

Individual compact camera and digital inverted microscope units.

Embryo time lapse culture dish Each well which holds an embryo is about the side of a full stop.

Primo Vision

A video recording of each embryo is obtained for up to 6 days growth depending on how the embryos grow. Embryo selection is either made on day 3, 5 or 6. Most abnormal growth events are observed during the first and second cleavages

Primo Vision

Embryo growth curves

Electronic ranking of embryo development capability

Key observation points currently correlated embryos least likely to create a pregnancy One cell to 3 cell (Video) 2 cell to 5 cell (Video) Re absorption of blastomeres (Video) Fragmented or arrested development ( video) Clear Abnormal development (Video) Extended period between 3 cell and 4 cell (Graph) Slow growth between key stages (Graph) Poor overall morphology

Morphology assessment complements time lapse imaging data Cleavage stage embryo Clear cells (Blastomeres) of equal size. Correct number of blastomeres for the embryo age Presence or absence of extra cellular fragmentation Advanced stage embryo Expanded blastocyst showing clear and well developed ICM and trophectoderm by embryo age day 5 or 6.

Day 3 good Prognosis embryo Optimal growth curve, no abnormal growth events during the cleavage stages and good morphology

Very good Prognosis embryo One that has reached a good quality blastocyst on day 5 or day 6 with no abnormal growth events and good cleavage morphology

Two examples demonstrating how we select the right embryos for transfer Video 1 Embryo Selection at day 3 of culture using time lapse Video 2 Embryo Selection at day 5 of culture using time lapse and morphology assessment

Embryo Selection at day 3 of culture using time lapse Patient had 5 embryos

Embryo 1 One cell (blastomere) splits into 3 directly.

Embryo 2 During the first division splits off a large fragment

Embryo 3 One cell (blastomere) splits into 3 directly.

Embryo 4 Evidence of blastomere fusion

Embryo 5 No abnormal growth events observed Transferred embryo and positive pregnancy test.

Embryo Selection at day 5 of culture using time lapse and morphology assessment resulting in a positive pregnancy