A multi-center evaluation of a novel IVF cryostorage device in an active clinical setting.

The objective of this study was to evaluate the function, and usability of a novel automated software-guided cryostorage system in an active IVF laboratory setting. The investigational device (ID) was installed at 3 IVF laboratories (sites: α, β, and γ). A total of 15 embryologists were trained to use the ID.

Evaluation of the TMRW vapor phase cryostorage platform using reproductive specimens and in vitro extended human embryo culture.

Objective: To assess the impact of shipment and storage of sperm, oocytes, and blastocysts in vapor phase nitrogen compared with static storage in liquid phase nitrogen.

Design: Prospective cohort-matched study.

Setting: Multiple in vitro fertilization laboratories in an in vitro fertilization network.

Maternal physiology and blastocyst morphology are correlated with an inherent difference in peri-implantation human embryo development.

Objective: To determine what patient and embryo characteristics are correlated with the developmental potential of the peri-implantation embryo.

Design: Retrospective study.

Setting: Research laboratory.

Comparison of electronic versus manual witnessing of procedures within the in vitro fertilization laboratory: impact on timing and efficiency.

Objective: To evaluate the impact of an electronic witnessing system (EWS) on witnessing standard operating procedures and to assess embryologist perceptions of the EWS.

Design: Prospective cohort study.

Setting: Private in vitro fertilization laboratory network.

Fused blastocysts as a consequence of group embryo culture: observations, complications, and potential solutions.

How embryos are cultured, in groups or individually, can influence their development and have other unforeseen impacts on subsequent assisted reproductive technologies. Although a group culture of embryos improves the blastocyst formation rates, this can create conditions wherein separate blastocysts may fuse. This fusion of 2 blastocysts can create unique logistic issues for embryo biopsy and genetic analysis.

Absence of SARS-CoV-2 (COVID-19 virus) within the IVF laboratory using strict patient screening and safety criteria.

Research Question: Is there a risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral exposure and potential cross-contamination from follicular fluid, culture media and vitrification solution within the IVF laboratory using strict patient screening and safety measures?

Design: This was a prospective clinical study. All women undergoing transvaginal oocyte retrieval were required to have a negative SARS-CoV-2 RNA test 3-5 days prior to the procedure. Male partners were not tested.

Human eggs, zygotes, and embryos express the receptor angiotensin 1-converting enzyme 2 and transmembrane serine protease 2 protein necessary for severe acute respiratory syndrome coronavirus 2 infection.

Objective: To study messenger ribonucleic acid (mRNA) and protein expressions of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry receptors (angiotensin 1-converting enzyme 2 [ACE2] and CD147) and proteases (transmembrane serine protease 2 [TMPRSS2] and cathepsin L [CTSL]) in human oocytes, embryos, and cumulus (CCs) and granulosa cells (GCs).

Design: Research study.

Setting: Clinical in vitro fertilization (IVF) treatment center.

AI in the treatment of fertility: key considerations.

Artificial intelligence (AI) has been proposed as a potential tool to help address many of the existing problems related with empirical or subjective assessments of clinical and embryological decision points during the treatment of infertility. AI technologies are reviewed and potential areas of implementation of algorithms are discussed, highlighting the importance of following a proper path for the development and validation of algorithms, including regulatory requirements, and the need for ecosystems containing enough quality data to generate it. As evidenced by the consensus of a group of experts in fertility if properly developed, it is believed that AI algorithms may help practitioners from around the globe to standardize, automate, and improve IVF outcomes for the benefit of patients.

Performance of a deep learning based neural network in the selection of human blastocysts for implantation.

Deep learning in in vitro fertilization is currently being evaluated in the development of assistive tools for the determination of transfer order and implantation potential using time-lapse data collected through expensive imaging hardware. Assistive tools and algorithms that can work with static images, however, can help in improving the access to care by enabling their use with images acquired from traditional microscopes that are available to virtually all fertility centers. Here, we evaluated the use of a deep convolutional neural network (CNN), trained using single timepoint images of embryos collected at 113 hr post-insemination, in embryo selection amongst 97 clinical patient cohorts (742 embryos) and observed an accuracy of 90% in choosing the highest quality embryo available.

Impact of a controlled culture temperature gradient on mouse embryo development and morphokinetics.

Research Question: Temperature control within the IVF laboratory is an important aspect of a quality control system, helping to reduce environmental stress and ensure good-quality embryo development. Temperature fluctuations are probably more common than expected and the optimal temperature for embryo culture is not known. Modern incubators offer the opportunity to examine the impact of culture temperature on preimplantation embryo development while controlling for other variables within the system.

Controversies in ART: can the IVF laboratory influence preimplantation embryo aneuploidy?

Published reports have indicated that rates of preimplantation embryo aneuploidy in a control donor population may vary between IVF centres. This suggests that location-specific conditions, in the clinic, IVF or genetics laboratory, may be influencing the chromosome dynamics or diagnosis. More recent reports suggest that rates of embryo mosaicism, representing mitotic errors, may vary between IVF centres.

Controversies in ART: considerations and risks for uninterrupted embryo culture.

With new time-lapse incubators, IVF laboratories have increased use of single step media, often used in an uninterrupted approach. This simplifies the culture process for embryologists, may help reduce costs, offers the potential to reduce cell handling and associated harmful environmental stressors, and improves embryo quality and outcomes. One could argue, however, that optimized quality control and culture conditions are required to implement uninterrupted culture successfully.

Forty years of IVF.

This monograph, written by the pioneers of IVF and reproductive medicine, celebrates the history, achievements, and medical advancements made over the last 40 years in this rapidly growing field.

Live-cell quantification and comparison of mammalian oocyte cytosolic lipid content between species, during development, and in relation to body composition using nonlinear vibrational microscopy.

Cytosolic lipids participate in the growth, development, and overall health of mammalian oocytes including many roles in cellular homeostasis. Significant emphasis has been placed on the study of lipids as a dynamic organelle, which in turn requires the development of tools and techniques to quantitate and compare how lipid content relates to cellular structure, function, and normalcy. Objectives of this study were to determine if nonlinear vibrational microscopy (e.

The why, the how and the when of PGS 2.0: current practices and expert opinions of fertility specialists, molecular biologists, and embryologists.

Study Question: We wanted to probe the opinions and current practices on preimplantation genetic screening (PGS), and more specifically on PGS in its newest form: PGS 2.0?

Study Finding: Consensus is lacking on which patient groups, if any at all, can benefit from PGS 2.0 and, a fortiori, whether all IVF patients should be offered PGS.

Optimizing the culture environment and embryo manipulation to help maintain embryo developmental potential.

With increased use of comprehensive chromosome screening (CCS), the question remains as to why some practices do not experience the same high levels of clinical success after implementation of the approach. Indeed, the debate surrounding the efficacy and usefulness of blastocyst biopsy and CCS continues. Importantly, several variables impact the success of an assisted reproductive technology cycle.

Antimüllerian hormone as a predictor of good-quality supernumerary blastocyst cryopreservation among women with levels <1 ng/mL versus 1-4 ng/mL.

Objective: To determine whether antimüllerian hormone (AMH) levels predict the availability of good-quality supernumerary blastocysts for cryopreservation.

Design: Retrospective study.

Setting: Two fertility centers.

Optimal human embryo culture.

A large contributor to success during in vitro fertilization (IVF) lies in the processes occurring within the IVF laboratory. These processes make up the "culture system." This system entails numerous procedures and technical steps that must be optimized to produce a competent embryo.

Decisions for the IVF laboratory: comparative analysis of embryo culture incubators.

Incubators in the IVF laboratory play a pivotal role in providing a stable and appropriate culture environment required for optimizing embryo development and clinical outcomes. With technological advances, several types of incubators are now available and careful consideration is required for selection. Examination of variables, such as recovery/stabilization of temperature, gas atmosphere and humidity, as well as understanding various approaches utilized by each device to regulate these variables, is critical.

Peering beneath the surface: novel imaging techniques to noninvasively select gametes and embryos for ART.

Embryo imaging has long been a critical tool for in vitro fertilization laboratories, aiding in morphological assessment of embryos, which remains the primary tool for embryo selection. With the recent emergence of clinically applicable real-time imaging systems to assess embryo morphokinetics, a renewed interest has emerged regarding noninvasive methods to assess gamete and embryo development as a means of inferring quality. Several studies exist that utilize novel imaging techniques to visualize or quantify intracellular components of gametes and embryos with the intent of correlating localization of organelles or molecular constitution with quality or outcome.

Could time-lapse embryo imaging reduce the need for biopsy and PGS?

Purpose: To review relevant studies examining the relationship between embryo morpho-kinetics and aneuploidy.

Methods: Search of Pubmed and Medline using relevant keywords pertaining to morphology, morphokinetics and embryonic aneuploidy, as well as examination of various reference lists and conference proceedings.

Results: An abundance of publications, both preliminary and peer-reviewed, have emerged regarding the usefulness of time-lapse imaging in tracking embryo development and improving embryo selection.