Embryo culture technologies in focus: A narrative review of time-lapse versus conventional incubation approaches

Embryo culture is a critical determinant of success in assisted reproductive technology (ART). Conventional incubation (CI) systems have long been the standard for supporting embryo development. Still, their reliance on periodic morphological assessments disrupts stable culture conditions and limits embryo evaluation to static observations. The introduction of time-lapse incubation (TLI) has addressed these challenges by enabling uninterrupted monitoring, providing continuous morphokinetic data, and supporting algorithm-driven embryo selection. This narrative review compares CI and TLI approaches, examining their principles, strengths, limitations, and reported clinical outcomes. While TLI has demonstrated advantages in laboratory workflow efficiency and embryo assessment, evidence regarding its impact on live birth rates remains inconsistent. Moreover, challenges related to high costs, accessibility in resource-limited settings, and ethical considerations warrant careful evaluation. Future directions point toward integrating artificial intelligence, non-invasive molecular profiling, and personalized embryo culture strategies to further enhance reproductive outcomes. A balanced appraisal of current evidence is essential to guide the responsible adoption of TLI within clinical practice.