Considerations on staffing levels for a modern assisted reproductive laboratory

Merging synthetic and real embryo data for advanced AI predictions

Accurate embryo morphology assessment is essential in assisted reproductive technology for selecting the most viable embryo. Artificial intelligence has the potential to enhance this process. However, the limited availability of embryo data presents challenges for training deep learning models. To address this, we trained two generative models using two datasets-one we created and made publicly available, and one existing public dataset-to generate synthetic embryo images at various cell stages, including 2-cell, 4-cell, 8-cell, morula, and blastocyst. These were combined with real images to train classification models for embryo cell stage prediction. Our results demonstrate that incorporating synthetic images alongside real data improved classification performance, with the model achieving 97% accuracy compared to 94.5% when trained solely on real data. This trend remained consistent when tested on an external Blastocyst dataset from a different clinic. Notably, even when trained exclusively on synthetic data and tested on real data, the model achieved a high accuracy of 92%. Furthermore, combining synthetic data from both generative models yielded better classification results than using data from a single generative model. Four embryologists evaluated the fidelity of the synthetic images through a Turing test, during which they annotated inaccuracies and offered feedback. The analysis showed the diffusion model outperformed the generative adversarial network, deceiving embryologists 66.6% versus 25.3% and achieving lower Fréchet inception distance scores.

IVF cycle safety when a positive passive air sampling occurs under laminar flow hood in absence of a detectable contamination in the embryo culture

Microbiological contamination in the embryo culture media might affect embryo early development and clinical outcomes during IVF procedures. Infections in the genital tract represent the most common causes of culture contamination, but also environmental air quality might have a detrimental effect on reproductive outcomes of infertile couples undergoing IVF procedures. Monitoring microbiological contamination in an embryology laboratory is mandatory and daily tests are performed under laminar vertical flow hood. In this study, we investigated the IVF outcome of procedures carried out during 5 years of laboratory activity when a positive passive air sampling occurs under laminar flow hood in the absence of clear contamination in the embryo culture. We performed 570 air samplings, and we isolated at least 1 CFU of microorganisms in the TSA settle plate in 13 cases (2.28%). No infections were suspected in the culture media given the absence of detectable microorganisms under the microscope or a turbidity/color change of culture media visible to the naked eye (0% contamination rate). There were no statistically significant differences in biochemical pregnancy, live birth rate, and abortion between the "contaminated" Group P and the "negative" Group N. Surprisingly, we found a better outcome in terms of clinical pregnancy rate in Group P as compared to Group N, a finding likely due to the accidental lower age of Group P (p = 0.0133). Data showed that, in the absence of a detectable contamination in the embryo culture media, IVF cycles are safe when an air positive sample occurs in Grade A environment.

Beyond Earth's bounds: navigating the frontiers of Assisted Reproductive Technologies (ART) in space

As interest in deep space travel grows exponentially, understanding human adaptation in becoming an interplanetary species is crucial. This includes the prospect of reproduction. This review summarizes recent updates and innovations in assisted reproductive technologies (ART) on Earth, while also discussing current challenges and areas for improvement in adapting ART studies to the space environment. We discuss the critical components of ART - gamete handling and preparation, fertilization, embryo culture, and cryopreservation - from the daily practice perspective of clinical embryologists and reproductive endocrinologists and lay out the complicated path ahead.In vitro embryo development in low Earth orbit and beyond remains questionable due to synergetic effects of microgravity and radiation-induced damage observed in simulated and actual in-space mammalian studies. Cryopreservation and long-term storage of frozen samples face substantial obstacles - temperature limitations, lack of trained personnel, and absence of adapted cosmic engineering options. We touch on recent innovations, which may offer potential solutions, such as microfluidic devices and automated systems. Lastly, we stress the necessity for intensive studies and the importance of an interdisciplinary approach to address numerous practical challenges in advancing reproductive medicine in space, with possible implications for both space exploration and terrestrial fertility treatments.

A micro-fabricated device (microICSI) improves porcine blastocyst development and procedural efficiency for both porcine intracytoplasmic sperm injection and human microinjection

PURPOSE

Intracytoplasmic sperm injection (ICSI) imparts physical stress on the oolemma of the oocyte and remains among the most technically demanding skills to master, with success rates related to experience and expertise. ICSI is also time-consuming and requires workflow management in the laboratory. This study presents a device designed to reduce the pressure on the oocyte during injection and investigates if this improves embryo development in a porcine model. The impact of this device on laboratory workflow was also assessed.

METHODS

Porcine oocytes were matured in vitro and injected with porcine sperm by conventional ICSI (C-ICSI) or with microICSI, an ICSI dish that supports up to 20 oocytes housed individually in microwells created through microfabrication. Data collected included set-up time, time to align the polar body, time to perform the injection, the number of hand adjustments between controllers, and degree of invagination at injection. Developmental parameters measured included cleavage and day 6 blastocyst rates. Blastocysts were differentially stained to assess cell numbers of the inner cell mass and trophectoderm. A pilot study with human donated MII oocytes injected with beads was also performed.

RESULTS

A significant increase in porcine blastocyst rate for microICSI compared to C-ICSI was observed, while cleavage rates and blastocyst cell numbers were comparable between treatments. Procedural efficiency of microinjection was significantly improved with microICSI compared to C-ICSI in both species.

CONCLUSION

The microICSI device demonstrated significant developmental and procedural benefits for porcine ICSI. A pilot study suggests human ICSI should benefit equally.