How to decrease EPL rate treating infertility?

Early pregnancy loss (EPL) is the most common complication of early pregnancy and has a negative impact on the couples reproductive experience, including depression and anxiety disorders. Embryo selection is one of the most important steps in achieving success of ART treatment. Selection of high implantation potency embryo can improve treatment outcome and decrease EPL and multiple pregnancy rate implementing selective single embryo transfer (SET). One of the noninvasive embryo selection methods is time-lapse based morphokinetic (TLM) evaluation of the embryonic development. So, the objective of the study was to compare EPL rate between conservative embryo cultivation/selection and TLM groups. Longitudinal cohort study of 376 couples undergoing ICSI cycles in private reproductology clinic iVF Riga was performed. Logistic regression analysis adjusted by age and autologous oocyte in TLM assessment and control group was done, so there were no statistically significant differences in biochemical, clinical and ongoing pregnancy rates per ET, but EPL rate per ET was still statistically significantly reduced: OR 0.41, 95%CI 0.17-0.98, p = 0.044. TLM embryo culturing and selection method is safe, reliable and noninvasive strategy for improvement ongoing pregnancy rate and decreasing EPL rates for patient undergoing infertility treatment.