Conclusion:
Use of TLI incubators appears to increase the cumulative live birth
rates in IVF providing additional reassuring data about the safety and
effectiveness of TLI incubators for clinical practice in IVF. The fact
that this effect on cumulative live birth rate has been seen with
single-step culture medium and not with sequential culture medium
(explored in our previous study) adds additional strength to our
hypothesis that TLI incubators do not affect embryo selection alone but
improve embryo quality through the uninterrupted culture conditions.
This forces a rethink of the interrelationships between the type of
incubator systems and type of the culture medium used in the clinical
laboratory. Research studies such as meta-analyses exploring the impact
of incubator systems should consider the type of culture medium used.
Further research is being undertaken at our unit to assess the impact of
not opening the incubator doors on day 3 in SC incubators to assess
whether this adaptation might confer some of the benefits of TLI systems
to SC incubators.