ABSTRACT
On June 11, 2013, a baby named Eva was born in Glasgow. Nine months previously, her embryo had been selected for implantation in her mother’s womb with the aid of time-lapse embryo imaging technology. Her birth made national headlines because she was the first person to be born from an IVF procedure that used “Early Embryo Viability Assessment” (Eeva) for embryo selection (BBC 2013). Although her parents insist that they intended to call their future daughter Eva before they ever heard about the test, the company that owns the Eeva technology, Auxogyn, boasts of the test’s significance as “the most important breakthrough in IVF in recent decades” in a press release entitled “Baby Eva Named after Pioneering IVF Test” (BBC 2013; Kbhandal 2013b). The visual nature of this technology is emphasized by the press release’s inclusion of a video of
Eva’s conception straight after the header (Kbhandal 2013a). The video shows a black-and-white image of the fertilized egg, which divides three times before the green-lettered word “HIGH” appears above it, referring to the embryo’s quality. The video is framed by the logos of the Glasgow fertility clinic (GCRM) and Eeva below and the caption “Baby Eva, born 11 June 2013” above. Two months prior to the Eeva news report, time-lapse embryo imaging had already been featured on BBC News as the latest breakthrough technology in IVF (Walsh 2013). This news item discussed a different embryo imaging technology, the EmbryoScope, which had followed 46 embryos through to birth.1 The interviewed specialist, Dr Simon Fishel, managing director of the CARE Fertility Group, similarly claims that time-lapse embryo imaging is an important breakthrough: “In the 35 years I have been in this field this is probably the most exciting and significant development that can be of value to all patients seeking IVF.” Notwithstanding the more or less groundbreaking technoscientific nature of these technologies, I will argue that they are also innovative in bringing into circulation a new set of images of early embryonic life. As these news stories indicate, in 2013 several fertility clinics in the UK started marketing this method of embryo selection to patients as an alternative to conventional selection; it has since become widespread clinical practice.2 Conventional selection is based on a daily visual examination of the embryos’ static morphological appearance. In order to examine them, embryologists have to remove the embryos from their incubator into a suboptimal environment under the microscope. The time-lapse imaging technologies, by contrast, allow for continuous observation by taking photographs every five to 20 minutes while the embryos remain undisturbed in the incubator. The resulting videos not only give increased insight into the appearance of the embryos, but also visualize a temporal dimension that remained invisible in the conventional method: the timing of cell divisions and the movements of embryonic growth. By matching these videos with the growth patterns of embryos that developed into healthy fetuses, the time-lapse apparatus suggests which embryos are most likely to implant and grow in the woman’s womb. The time-lapse embryo imaging apparatus gives embryologists more visual and temporal information about the developing embryos, enabling them to avoid implanting those that are less likely to be viable while maintaining stable culturing conditions in the incubator. According to some biomedical studies, this approach results in increased implantation, pregnancy and live birth rates (Meseguer et al. 2012; Chen et al. 2013), while others – including a Cochrane review – hold that the current evidence of increased pregnancy or live birth rates is too limited to justify the routine adoption of time-lapse embryo imaging (Armstrong et al. 2015; Racowsky et al. 2015). Currently, three different time-lapse imaging systems, produced by two biotechnology companies, are used in fertility clinics: Auxogyn’s Eeva and Vitrolife’s EmbryoScope and Primo Vision.3 This alternative approach to embryo selection introduces moving images of embryonic development into the clinical experience of IVF. The resulting new set of embryo images circulates beyond the laboratory into the clinic, the
patient’s private sphere, and public discourses. Through these visual mediations, embryo selection becomes a more visible step in the IVF process – one that informs patient communication in fertility clinics and requires new decisions and financial investments from intended parents. As with other, existing medical imagery of prenatal life, it is hard to disentangle the medical and cultural meanings of these visual mediations of embryonic development (Van Dijck 2001, 103-104). As names like EmbryoScope and Primo Vision suggest, the observation and visualization of embryos play a key role both in the method and the marketing of time-lapse technology. The visualization of embryos in time-lapse imaging is also instrumental in introducing temporal parameters as key indicators of viability in embryo assessment. The timing of the observed embryonic developmental process forms the basis for selecting which embryo(s) will be implanted in the woman’s womb. Time-lapse embryo imaging thus brings together the innovations of visualized development, temporal assessment, uninterrupted incubation, increased digitization and standardization of selection. Although scholarly attention has been paid to the use of time-lapse microcinematography in a scientific research context – most notably by Landecker (2006, 2012) – the embryo videos produced in a clinical setting have not yet received critical reflection. In this chapter, I draw attention to the visualization of embryonic development in time-lapse embryo imaging. I first explore how, and with what effects, embryos are visualized in time-lapse videos. Emerging in the wake of an increasingly visual interface with prenatal life, such as the iconic imagery of
micro-injection and fetal ultrasound, both of which have had a profound impact on the public and private imagination of the reproductive process, time-lapse embryo videos add yet another visual dimension to the encounter with early human life on screen (Duden 1993; Van Dijck 2001; Franklin 2013). How can we position these embryo videos in relation to existing visual mediations of prenatal life? What conceptualizations of embryos emerge from these videos and the ways in which they are framed by fertility clinics and biotechnology companies? How, and with what effects, do they engage human origin stories and the teleology of the reproductive process? In dialogue with scholarship on reproductive technologies in feminist technoscience studies, I engage with these concerns through a visual analysis of the framing of the time-lapse embryo videos – particularly Auxogyn’s Eeva videos – that are publicly disseminated by fertility clinics, biotechnology companies and media outlets. In this reading of time-lapse embryo imagery, I will distinguish three approaches to visualizing embryos in the videos – as individuals, collectives, and populations – and consider what the implications may be if time-lapse imaging should become the “new normal” in embryo selection.
