First births using a closed, simplified IVF culture system in a mobile IVF laboratory: a proof-of-concept study

RESEARCH QUESTION: Can pregnancy be achieved using a simplified embryo culture system within a mobile IVF laboratory? DESIGN: Case series design, describing the results of a pilot study investigating the use of a simplified, closed, low-cost embryo culture system in a prototype mobile IVF laboratory. A mild ovarian stimulation protocol was used in all cycles. Follicular aspiration was performed in a clinical setting, while oocyte fertilization, embryo culture and embryo transfers were carried out in a mobile unit using the Walking Egg simplified embryo culture system. RESULTS: From 12 cycles initiated, no oocytes were obtained in one cycle, fertilization failed in another cycle due to a low number of oocytes which were predominantly immature, and 10 cycles continued to embryo culture. Of these 10 cycles, a single embryo transfer was performed in five cycles, and two embryos were transferred in the remaining five cycles. Five of the 10 women became pregnant; of these, one miscarried and four had a live birth. CONCLUSION: Proof of concept, even with a limited sample size, for the use of mild stimulation and low-cost embryo culture in a mobile laboratory is presented. These promising results support the use of a mobile IVF laboratory in areas where access to ART is costly and limited due to few IVF centres which are mainly located in cosmopolitan centres.