Improved implantation rates of day 3 embryo transfers with the use of an automated time lapse enabled test to aid in embryo selection

An automated noninvasive time-lapse embryo assessment test can be used together with embryo morphology to increase implantation rates after day 3 transfer.

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G. David Adamson, M.D., Mary E. Abusief, M.D., Lourella Palao, B.S., Jennifer Witmer, M.S., Lonyl M. Palao, M.S., Marina Gvakharia, M.D., Ph.D.

Volume 105, Issue 2, Pages 369-375



To determine if an automated time-lapse test (TL-test) combined with traditional morphology for embryo selection and day 3 transfer results in improved clinical outcomes.


Prospective concurrent-controlled pilot study.


IVF clinic and laboratory in the United States.


A total of 319 female patients <41 years old, with day 3 embryo transfer, fewer than three failed IVF cycles, and at least four zygotes (2-pronuclear) on day 1. Intervention(s):

Automated time-lapse embryo assessment combined with morphologic assessment in the study (test) group compared with morphologic assessment only (control group).

Main Outcome Measure(s):

Embryo implantation, pregnancy, and multiple pregnancy rates. Subanalysis of implantation potential of embryos based on the TL-test (TL-high vs. TL-low) scores.


Implantation and clinical pregnancy rates were significantly higher in the test group compared with the control group (implantation rates 30.2% vs. 19.0%, clinical pregnancy rates 46.0% vs. 32.1%, respectively). Multiple pregnancy rates were not statistically different (26.7% vs. 18.3%). Test group patients receiving at least one TL-high embryo had significantly higher implantation rates than patients receiving only TL-low embryos (36.8% vs. 20.6%). TL-high compared with TL-low embryos had significantly higher implantation rates (44.7% vs. 20.5%). Among morphologically good embryos, TL-high embryos were more likely to implant than TL-low embryos (44.1% vs. 20.6%).


This is the first report demonstrating improved implantation rates in patients receiving day 3 embryo transfers based on the combined use of a TL-test along and traditional morphology. Our findings confirm that the noninvasive TL-test adds valuable information to traditional morphologic grading.

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Fertility and Sterility

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