Objective: To compare the effect of a fully undisturbed culture strategy over a sequential one on embryo in vitro development and clinical outcomes in intracytoplasmic sperm injection (ICSI) cycles.
Design: Retrospective cohort study.
Setting: University-affiliated private IVF center.
Study Question: Is the automatic embryo grading function of specific time-lapse systems clinically useful as a decision support tool for IVF laboratories?
Summary Answer: Blastocyst grading according to the automatic scoring system is directly associated with the likelihood of implantation and live birth, at least in treatments without preimplantation genetic testing for aneuploidy (PGT-A).
What Is Known Already: Several embryo selection algorithms have been described since the introduction of time-lapse technology in IVF laboratories, but no one algorithm has yet been sufficiently consolidated for universal use. Multicentric models based on automated grading systems offer promise for standardization of embryo selection.