16 Dec EmbryoScope – does it really help IVF patients?
IVF patients are now offered a bewildering array of ‘add-on’ treatments. And a growing number of fertility clinics now use a machine called the EmbryoScope. What is it and does it actually benefit IVF patients? Some clinics say yes. Others say maybe. Actually, the jury is out. No large-scale randomised trials have been done. But that doesn’t mean you should write it off – so read on.
EmbryoScope is a special incubator, a controlled environment, which helps to maintain the necessary physiological conditions for an embryo to survive. It’s basically a big white box, incorporating a time-lapse photography system. This, the sexier bit, boasts an inbuilt camera that takes multiple consecutive images and allows the embryologist to view embryo development/cell-division over a period of time. EmbryoScope can assemble these images to create a short film, playing back embryo growth. It’s an impressive piece of kit.
Why do so many clinics use it? The thinking is that EmbryoScope gives more precise information on how each embryo is growing and therefore allows the best- quality embryo(s) to be chosen for transfer. This should, in theory, give the best chance of a successful pregnancy. Some clinics say that the time-lapse generated images may show an event in an embryo’s development that would not otherwise have been observed. Most users say that reviewing time-lapse images can, at the very least, help fine-tune embryo selection.
EmbryoScope provides a uniquely sealed environment for the embryos. How important is that? Standard IVF involves embryos being removed a handful of times for ‘manual’ monitoring. This potentially puts them at risk from nasties in the outside world. EmbryoScope keeps the embryos undisturbed in a stable culture environment.
So does it actually improve the chances of an IVF pregnancy? We sampled some clinic websites at random (those who use EmbryoScope, that is). Most say positive things. One clinic calls it the most exciting development since IVF itself. Another says the average pregnancy rate for people who choose Embryoscope is 15% higher than for those who don’t. A third, more soberly, says that only patients who’ve had repeated miscarriage failure, or are using surgically-retrieved testicular sperm or frozen eggs, may benefit from the use of EmbryoScope. Take your pick. Clinic feedback is nice. But it’s no substitute for fully-blown research.
The downside? Let’s talk money. EmbryoScope costs around £700 in the UK and maybe a little more in some London clinics. Some providers include its use in the package price. Which is fine, but there has to be a mark-up or commercial upside somewhere for the clinic to be able to offer that.
Professor Robert Winston claims the benefits of EmbryoScope are not clear. He says there may be a very slight improvement due to the embryos being kept in the incubator and having the time-lapse technology watching over them. Other critics say there’s no need for constant embryo monitoring and that the traditional light microscope combined with embryologist skill can pick out the best embryos anyway.
Our verdict? Until we see some large-scale trials it’s hard to say for sure how beneficial EmbryoScope really is for IVF patients. But at the moment – fingers crossed – it looks reasonably promising based on some smaller trials. There are cheaper add-ons out there with stronger research behind them (see embryo glue, from the same makers as EmbryoScope, and endometrial scratching). But for those who can’t wait – the constant fertility-treatment dilemma – we reckon it’s worth considering.
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