Time-lapse & AI in embryo selection
Choosing the “best” embryo for transfer is one of the most critical points in IVF. Two technologies promise to improve it: time-lapse recording and, more recently, artificial intelligence.
They sound impressive — and they do have real advantages. But the question that matters for you is different: do they increase the chance of having a baby?
What is time-lapse technology?
These are special incubators with a built-in camera that photograph the embryos at regular intervals, creating a continuous “video” of their development. This lets the embryologist watch every stage without having to remove the embryos from the incubator.
The main, undisputed advantage is undisturbed culture: the embryos stay in stable, ideal conditions of temperature and gases, without the fluctuations caused by conventional checks under the microscope.
Does time-lapse improve birth rates?
Here we must be precise. Despite its advantages for culture, there is no sufficient high-quality evidence that time-lapse, on its own, increases the live-birth rate compared with conventional incubators.
The Cochrane review concludes that the relevant evidence is insufficient. A large, recent randomized trial (TILT, 2024) confirmed that time-lapse gave no advantage over the conventional method.
What does artificial intelligence add?
Artificial-intelligence systems are “trained” on thousands of embryo images and videos so as to grade each embryo’s potential automatically and objectively. The appeal is consistency: AI does not tire and is not affected by observer subjectivity.
This standardization can be useful, especially for uniformity between embryologists and centres. But it is a tool to assist, not to replace, clinical judgement.
Does AI increase births?
To date, not in any proven way. Recent randomized trials compared AI embryo selection against selection by experienced embryologists and did not show AI to be superior for the pregnancy or birth rate.
Artificial intelligence appears able to “match” the performance of a good embryologist, but not, for now, to surpass it in a way that translates into more babies.
Does this technology have value, then?
Yes, but with realistic expectations. Undisturbed culture, more objective documentation and the ability to review embryo development are real and useful benefits for a modern laboratory.
The mistake would be to present them as technologies that “guarantee” or clearly increase the chance of success. They should not become an expensive add-on with promises unsupported by the data.
What should you ask your centre?
Ask whether time-lapse or AI carry an extra charge and, if so, with what evidence of benefit. Ask whether they are used as part of good laboratory practice or as a commercial “package”.
A trustworthy centre will explain honestly that these are useful tools that improve the process, without overstating the success rates.
Summary
Time-lapse recording and artificial intelligence are modern tools with real advantages: undisturbed embryo culture and more objective, standardized assessment. However, the high-quality evidence — the Cochrane review, the TILT trial and recent randomized trials of AI — does not show that they increase the live-birth rate compared with the conventional method or selection by an experienced embryologist. They are useful aids, not a guarantee of success, and should not be offered as expensive add-ons with exaggerated promises.
⚕ Medically reviewed by Prof. Stratis Kolibianakis · Thessaloniki Medical Association Reg. No. 16340
ARTICLE 8 · IVF
