Daniel Hlinka, MVD., PhD

Daniel Hlinka, MVD., PhD

ESHRE certified Senior clinical embryologist

Previously he has led embryological laboratories in:

  • II. gyn.-obst. clinic Košice, Slovakia
  • KRM Zlín, Czech Republic
  • Repromeda Brno, Czech Republic
  • Pronatal Prague, Czech Republic

Non-invasive embryo monitoring (time-lapse) – gentle way to choose the best

When the ICSI method was initially pioneered Dr Daniel Hlinka was the first to successfully apply this method in the Slovak Republic, resulting in the birth of the first such child in 1994.
Pioneering is still the challenge.
So when the first camera enabling continual monitoring of the embryos during their first days in incubation appeared, he was the first to introduce this method into clinical practice.
His new clinic Prague Fertility Centre, opened by him and gynaecologist Dr Sonia Lazarovska, is now state of the art. He feels that this method gives to embryologists a completely new tool. Equipped with the latest technologies and run by the most experienced personnel, the clinic has all the most up to date requirements.

From the very beginning of the existence of assisted reproduction techniques embryologists have been trying to find the most effective way for embryo selection. Our aims are clear:

  • Maximise the success rate per embryo transfer
  • Minimize early miscarriages rate and, subsequently minimise the stress of the patient
  • Minimize the stress of the embryos during in vitro cultivation

Until recently we had to rely on static observations where embryos had to be removed from the incubator and watched under a microscope. Obviously, under such arrangements it is not possible to fully benefit from embryo development and the data generated throughout the embryo development processes because they are very dynamic by nature. Moreover, the evaluation of embryonic developmental abilities according to the static microscopic observation is negatively influenced by the depth of subjectivity in the assessment and by the questionable relevance of the measured morphological parameters.

The need for a dynamic method became essential. Consequently the Prague Fertility Center was one of the very first IVF Centers worldwide to introduce a time lapse monitoring system – PrimoVision – into their daily routine. (Hlinka, D., Dudas, M., Rutarova, J., et al. Permanent embryo monitoring and exact timing of early cleavages allow reliable prediction of human embryo viability, P-176 – Abstract of the 26th Annual Meeting of the European Society of Human Reproduction and Embryology, Rome, Italy, 27 –30 June 2010)

The new equipment continuously monitors embryos with time-lapse video – a camera that is placed directly in the incubator takes a picture every 20 –30 minutes which helps to evaluate all usual parameters as well as time-depended parameters. There is no need to remove the embryos from the incubator to watch them under a microscope. The embryo’s envi­ronment stays constant with optimal temperature and CO2 concentration, so it is safeguarded from changes in temperature, light exposure, etc.

Since we are using PrimoVision for more than 4 years in the Prague Fertility Center, we now can state that the most considerable benefit of this method is that it allows the detection of abnormal cleavages leading to the occurrence of chromosomal aberations which are a major cause of spontaneous miscarriages or of birth defects.

In a simplified way we can say that this non-invasive method gives us the tool for aneuploidy (wrong number of chromosomes) prediction as an alternative to invasive genetic aneuploidy screening (requires the biopsy of 1–2 cells from the embryo). By using non-invasive embryo imaging we can reveal fully aneuploidic embryos as well as mosaic embryos consisting of aneuploid/euploid cells frequently leading to early miscarriages.

Taken together, time-lapse or embryo monitoring opens a new opportunity for exact measurement of the early phases of human embryo development and provides a novel powerful strategy for objective early embryo pre-selection. The developmental abilities of human embryos can be predicted by measurement of their cell cycles. Continuous non-invasive embryo monitoring allows an exact measurement of these phases of human embryo development. Moreover, objective and non-invasive imaging of embryo characteristics allows the detection of abnormal cleavages leading to the occurence of chromosomal malsegregation.

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