Microfluidics for sperm analysis and selection

Cervix chip mimicking cervical microenvironment for quantifying sperm locomotion

As the gate for sperm swimming into the female reproductive tract, cervix is full of cervical mucus, which plays an important role in sperm locomotion. The fact that sperm cannot pass through the cervical mucus-cervix microenvironment will cause the male infertility. However, how the sperm swim across the cervix microenvironment remains elusive. We used hyaluronic acid (HA), a substitute of cervical mucus to mimic cervix microenvironment and designed a cervix chip to study sperm selection and behavior. An accumulation of sperm in HA confirmed that HA served as a reservoir for sperm, similar to cervical mucus. We found that sperm escaping from HA exhibited higher motility than the sperm accessing into HA, suggesting that HA functions as a filter to select sperm with high activity. Our findings construct a practical platform to explore the sophisticated interaction of sperm with cervix microenvironment, with elaborate swimming indicators thus provide a promising cervix chip for sperm selection with kinematic features on-demand. What's more, the cervix chip allows the convenient use in clinical infertility diagnosis, owing to the advantage of simple, fast and high efficiency.

Separation of motile human sperms in a T-shaped sealed microchannel

Microfluidic methods act as an effective motile sperm separation technique used in infertility treatments. This work presents a standalone microfluidic device to separate motile sperm cells from non-motile sperm cells and debris. The separation mechanism is based on the centrifugal force acting on sperms and the ability of progressive motile sperms to swim upstream. The separation of motile sperm is carried out using a simple T-shaped microchannel which constitutes three reservoirs: one inlet and two outlets. Herein, one of the outlets is kept sealed. The sealed channel leads to a high-velocity gradient and a rheotaxis zone at the T junction resulting in the separation of motile sperms. Separated sperms are isolated in a sealed channel with a low Reynolds number flow so that sperms cannot have a net displacement, which ensures that the sperms do not re-enter the fluid flow. CFD simulation is conducted to study the flow fields inside the channel and experimental investigation is carried to observe the separation behaviour of sperms. The reported device provides 100% sperm separation efficiency and ensures the entrapment of sperm cells for a longer period. A modified colorimetric nitroblue tetrazolium test conducted on separated sperm cells shows that there is only a marginal increase in superoxide (O₂ ^-) production, proving normal sperm integrity. This device offers an effective and safe alternative to conventional sperm sorting methods.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13534-022-00229-9.

The use of fresh compared to frozen ejaculated sperm has no impact on fresh embryo transfer cycle reproductive outcomes

PURPOSE

To compare the reproductive outcomes of fresh embryo transfer (ET) cycles utilizing fresh versus frozen ejaculated sperm.

METHODS

First autologous fresh embryo transfer cycles at a single high-volume academic institution between 2013 and 2019 were retrospectively reviewed. IVF cycles using ejaculated sperm were included, and cycles using donor or surgically retrieved sperm were excluded. Sperm concentration was stratified as ≥ 5 and < 5 million/ml. The primary outcome was live birth, and the secondary outcomes were clinical intrauterine pregnancy (IUP) and miscarriage. A multivariable logistic regression model for the aforementioned outcomes was adjusted a priori for sperm concentration as well as maternal and paternal age.

RESULTS

A total of 6128 couples were included. Of these, 5780 (94.3%) utilized fresh sperm, and 348 (5.7%) frozen sperm. A total of 5716 (93.2%) had sperm concentrations ≥ 5 million/ml and 412 (6.7%) had sperm concentrations < 5 million/ml. On multivariable logistic regression, the use of freshly ejaculated sperm was not associated with significantly different odds of clinical IUP, miscarriage, or live birth when compared to cycles using frozen sperm.

CONCLUSION

For couples conceiving via fresh ET, the use of fresh versus frozen ejaculated sperm is not associated with reproductive outcomes.

Lab on a chip devices for fertility: from proof-of-concept to clinical impact

Microfluidics offers tremendous opportunities to understand the underlying biology of fertilization at the single-cell level and improve infertility management, however, its true clinical impact is yet to be realized. Lab-on-a-chip devices have generally failed to diffuse into clinical practice due to issues associated with their translation or their practicality and performance in clinical settings. In this perspective, I reflect on how the full potential of microfluidic technologies for fertility can be realized by considering regulatory and manufacturing considerations at the development stage and by redefining our developmental goals to directly target the ultimate clinical needs. I also challenge the common rationale around developing technologies for infertility treatment based on reducing cost and complexity in operation as the ultimate outcome is invaluable, human life.

Analytical approach to chiral active systems: suppressed phase separation of interacting Brownian circle swimmers

We consider chirality in active systems by exemplarily studying the phase behavior of planar systems of interacting Brownian circle swimmers with a spherical shape. For this purpose, we derive a predictive field theory that is able to describe the collective dynamics of circle swimmers. The theory yields a mapping between circle swimmers and noncircling active Brownian particles and predicts that the angular propulsion of the particles leads to a suppression of their motility-induced phase separation, being in line with recent simulation results. In addition, the theory provides analytical expressions for the spinodal corresponding to the onset of motility-induced phase separation and the associated critical point as well as for their dependence on the angular propulsion of the circle swimmers. We confirm our findings by Brownian dynamics simulations. The agreement between results from theory and simulations is found to be good.

Rheotaxis quality index: a new parameter that reveals male mammalian in vivo fertility and low sperm DNA fragmentation

The female reproductive tract simultaneously guides and selects high-quality sperm using rheotaxis in mammalian species. Sperm quality, however, is traditionally evaluated only by their movement velocities and concentration using computer-assisted sperm analysis (CASA), which ignores sperm rheotaxis. Here, by mimicking the female reproductive tracts' dimensions and hydrodynamic features, a new method is introduced to quantify sperm rheotaxis ability for evaluating semen quality. The combination of our RHEOtaxis quaLity indEX (RHEOLEX) and motile sperm concentration is able to predict sperm fertility levels in artificial insemination at various shear rates within 5 minutes. This means that RHEOLEX could be a biomarker for determining male in vivo fertility, unlike conventional semen quality parameters which fail to provide statistically significant predictions. In addition, a high RHEOLEX is associated with a low DNA fragmentation index (DFI), showing that this new parameter is able to identify low-DFI samples. Not only does this work highlight the importance of rheotaxis in determining male in vivo fertility, but it also provides a solid benchmark for developing fast microfluidic devices for male fertility prediction as well as DFI. Last, the data imply that the female reproductive tract might use rheotaxis to keep sperm with fragmented DNA from reaching the fertilization site.

Does Choosing Microfluidics for Sperm Sorting Offer an Advantage to Improve Clinical Pregnancies in Donor Egg Recipients?

Background:

Microfluidics (MF), an advanced sperm sorting technology results in the extraction of spermatozoa with higher DNA integrity and lower DNA damage compared to existing conventional sperm sorting methods.

Aims:

The aim of the present study is to assess the efficiency of MF and to isolate the best spermatozoa for intracytoplasmic sperm injection (ICSI) over the density gradient (DG) technique.

Study Setting and Design:

We recruited couples who choose the oocyte donation programme for this study to eliminate confounding factors associated with oocyte quality.

Materials and Methods:

Sperm was processed by MF (n = 180) and DG (n = 151). ICSI was performed and positive pregnancy, miscarriage and clinical pregnancy rates were compared.

Statistical Analysis:

All variables were analysed using Graph Pad Prism 5. The unpaired two-tailed t-test was used to assess the significance. A value of P < 0.05 was considered statistically significant.

Results:

There was no significant difference in pregnancy rates between the groups. However, a clear demarcation is seen in terms of clinical pregnancy rates, where the DG group achieved higher clinical pregnancies (91.7%) compared to the MF group (80.7%). Further, we compared miscarriage rates and biochemical pregnancies, and found a significantly higher miscarriage and biochemical pregnancy rate in the MF group (14.5% and 4%, respectively) compared to the DG group (6% and 1%, respectively).

Conclusions:

Based on the available literature, we anticipated a higher clinical pregnancy rate with MF compared with conventional processing. Our results show MF does not have any add-on positive effect on clinical pregnancy rate.

High-Frequency Ultrasound Boosts Bull and Human Sperm Motility

Sperm motility is a significant predictor of male fertility potential and is directly linked to fertilization success in both natural and some forms of assisted reproduction. Sperm motility can be impaired by both genetic and environmental factors, with asthenozoospermia being a common clinical presentation. Moreover, in the setting of assisted reproductive technology clinics, there is a distinct absence of effective and noninvasive technology to increase sperm motility without detriment to the sperm cells. Here, a new method is presented to boost sperm motility by increasing the intracellular rate of metabolic activity using high frequency ultrasound. An increase of 34% in curvilinear velocity (VCL), 10% in linearity, and 32% in the number of motile sperm cells is shown by rendering immotile sperm motile, after just 20 s exposure. A similar effect with an increase of 15% in VCL treating human sperm with the same setting is also identified. This cell level mechanotherapy approach causes no significant change in cell viability or DNA fragmentation index, and, as such, has the potential to be applied to encourage natural fertilization or less invasive treatment choices such as in vitro fertilization rather than intracytoplasmic injection.

Multi-dimensional-double-spiral (MDDS) inertial microfluidic platform for sperm isolation directly from the raw semen sample

Here, we propose a fully-automated platform using a spiral inertial microfluidic device for standardized semen preparation that can process patient-derived semen samples with diverse fluidic conditions without any pre-washing steps. We utilized the multi-dimensional double spiral (MDDS) device to effectively isolate sperm cells from other non-sperm seminal cells (e.g., leukocytes) in the semen sample. The recirculation platform was employed to minimize sample dependency and achieve highly purified and concentrated (up to tenfold) sperm cells in a rapid and fully-automated manner (~ 10 min processing time for 50 mL of diluted semen sample). The clinical (raw) semen samples obtained from healthy donors were directly used without any pre-washing step to evaluate the developed separation platform, which showed excellent performance with ~ 80% of sperm cell recovery, and > 99.95% and > 98% removal of 10-μm beads (a surrogate for leukocytes) from low-viscosity and high-viscosity semen samples, respectively. We expect that the novel platform will be an efficient and automated tool to achieve purified sperm cells directly from raw semen samples for assisted reproductive technologies (ARTs) as an alternative to density centrifugation or swim-up methods, which often suffer from the low recovery of sperm cells and labor-intensive steps.

Unraveling the Kinematics of Sperm Motion by Reconstructing the Flagellar Wave Motion in 3D

Sperm swim through the female reproductive tract by propagating a 3D flagellar wave that is self-regulatory in nature and driven by dynein motors. Traditional microscopy methods fail to capture the full dynamics of sperm flagellar activity as they only image and analyze sperm motility in 2D. Here, an automated platform to analyze sperm swimming behavior in 3D by using thin-lens approximation and high-speed dark field microscopy to reconstruct the flagellar waveform in 3D is presented. It is found that head-tethered mouse sperm exhibit a rolling beating behavior in 3D with the beating frequency of 6.2 Hz using spectral analysis. The flagellar waveform bends in 3D, particularly in the distal regions, but is only weakly nonplanar and ambidextrous in nature, with the local helicity along the flagellum fluctuating between clockwise and counterclockwise handedness. These findings suggest a nonpersistent flagellar helicity. This method provides new opportunities for the accurate measurement of the full motion of eukaryotic flagella and cilia which is essential for a biophysical understanding of their activation by dynein motors.

Deep Learning-Enabled Technologies for Bioimage Analysis

Deep learning (DL) is a subfield of machine learning (ML), which has recently demonstrated its potency to significantly improve the quantification and classification workflows in biomedical and clinical applications. Among the end applications profoundly benefitting from DL, cellular morphology quantification is one of the pioneers. Here, we first briefly explain fundamental concepts in DL and then we review some of the emerging DL-enabled applications in cell morphology quantification in the fields of embryology, point-of-care ovulation testing, as a predictive tool for fetal heart pregnancy, cancer diagnostics via classification of cancer histology images, autosomal polycystic kidney disease, and chronic kidney diseases.

Micro/nanorobots for precise drug delivery via targeted transport and triggered release: a review

Micro/nanorobots that can effectively convert diverse energy sources into movement can revolutionize the field of pharmaceutical, particularly targeted drug delivery. By targeted transport and triggered release, drug can be delivered to targeted tissues or body sites. Targeted transport is discussed with different actuation energy sources including self-propelled (H₂O₂ and enzymes), external field-propelled (light, electrical, acoustics and magnetic field) and motile microorganism-propelled (bacterium, sperm, and contractile and immune cells) types. Triggered release systems including physiological environment, external fields and other mechanisms categories are also discussed here for the first time. With different transport and triggered release systems, micro/nanorobots achieved the goal of precise delivery of therapeutics. This review may provide a different perspective or referable guidance for the future development of more flexible targeted delivery systems.

Lower reactive oxygen species production and faster swimming speed of human sperm cells on nanodiamond spin-coated glass substrates

The sperm selection stage is what assisted reproductive technologies have in common and is crucial as it affects the success of the treatment cycle. The employment of microfluidic platforms for sperm selection has emerged showing promising results. In microfluidic platforms, sperm cells encounter micro-confined environments meanwhile having contact with channel walls and surfaces. Modification of contact surfaces using nanoparticles leads to the alteration of surface characteristics which in turn affects sperm behavior especially motility which is an indicator for sperm health. In this article, we present the results of investigating the motility parameters of sperm cells in contact with surface-modified glass substrates using nanodiamond particles. The results show that the sperm swimming velocities are significantly improved within the range of 12%-52% compared to the control surface (untreated). Reactive oxygen species production is also decreased by 14% justifying the increase in swimming speed. Taken together, bonding these modified surfaces to sperm selection microfluidic devices could enhance their efficiency and further improve their outcomes offering new solutions to patients facing infertility.

Microfluidic-Based Droplets for Advanced Regenerative Medicine: Current Challenges and Future Trends

Microfluidics is a promising approach for the facile and large-scale fabrication of monodispersed droplets for various applications in biomedicine. This technology has demonstrated great potential to address the limitations of regenerative medicine. Microfluidics provides safe, accurate, reliable, and cost-effective methods for encapsulating different stem cells, gametes, biomaterials, biomolecules, reagents, genes, and nanoparticles inside picoliter-sized droplets or droplet-derived microgels for different applications. Moreover, microenvironments made using such droplets can mimic niches of stem cells for cell therapy purposes, simulate native extracellular matrix (ECM) for tissue engineering applications, and remove challenges in cell encapsulation and three-dimensional (3D) culture methods. The fabrication of droplets using microfluidics also provides controllable microenvironments for manipulating gametes, fertilization, and embryo cultures for reproductive medicine. This review focuses on the relevant studies, and the latest progress in applying droplets in stem cell therapy, tissue engineering, reproductive biology, and gene therapy are separately evaluated. In the end, we discuss the challenges ahead in the field of microfluidics-based droplets for advanced regenerative medicine.

Cross flow coupled with inertial focusing for separation of human sperm cells from semen and simulated TESE samples

A triplet spiral channel coupled with cross-flow filtration has been designed and fabricated in an effort to separate sperm cells from either semen or simulated testicular sperm extraction (TESE) samples. This device separates a fraction of cells from the sample by taking advantage of inertial focusing combined with hydrodynamic filtration in multiple micro-slits. Compared to the conventional swim-up technique, the proposed microfluidic device is capable of efficiently separating sperm cells without any tedious semen sample processing and centrifugation steps with a lower level of reactive oxygen species and DNA fragmentation. The device processing capability on the simulated TESE samples confirmed its proficiency in retrieving sperm cells from the samples with an approximate yield of 76%. Conclusively, the introduced microfluidic device can pave the path to proficiently separate sperm cells in assisted reproductive treatment cycles.

Virus removal from semen with a pinched flow fractionation microfluidic chip

Nowadays pigs are bred with artificial insemination to reduce costs and transportation. To prevent the spread of diseases, it is important to test semen samples for viruses. Screening techniques applied are enzyme-linked immunosorbent assays and/or polymerase chain reaction, which are labor-intensive and expensive methods. In contrast to the current used screening techniques, it is possible to remove viruses physically from semen. However, existing methods for virus removal techniques have a low yield of spermatozoa. Therefore, we have developed a microfluidic chip that performs size-based separation of viruses and spermatozoa in boar semen samples, thereby having the potential to reduce the risk of disease spreading in the context of artificial insemination in the veterinary industry. As the head of a spermatozoon is at least twenty times larger than a virus particle, the particle size can be used to achieve separation, resulting in a semen sample with lower viral load and of higher quality. To achieve the size separation, our microfluidic device is based on pinched-flow fractionation. A model virus, cowpea chlorotic mottle virus, was used and spiked to porcine semen samples. With the proposed microfluidic chip and the optimized flow parameters, at least 84 ± 4% of the model viruses were removed from the semen. The remaining virus contamination is caused by the model virus adhering to spermatozoa instead of the separation technique. The spermatozoa recovery was 86 ± 6%, which is an enormous improvement in yield compared to existing virus removal techniques.

Simulating nature in sperm selection for assisted reproduction

Sperm selection in the female reproductive tract (FRT) is sophisticated. Only about 1,000 sperm out of millions in an ejaculate reach the fallopian tube and thus have a chance of fertilizing an oocyte. In assisted reproduction techniques, sperm are usually selected using their density or motility, characteristics that do not reflect their fertilization competence and, therefore, might result in failure to fertilize the oocyte. Although sperm processing in in vitro fertilization (IVF) and intrauterine insemination (IUI) bypasses many of the selection processes in the FRT, selection by the cumulus mass and the zona pellucida remain intact. By contrast, the direct injection of a sperm into an oocyte in intracytoplasmic sperm injection (ICSI) bypasses all natural selection barriers and, therefore, increases the risk of transferring paternal defects such as fragmented DNA and genomic abnormalities in sperm to the resulting child. Research into surrogate markers of fertilization potential and into simulating the natural sperm selection processes has progressed. However, methods of sperm isolation - such as hyaluronic acid-based selection and microfluidic isolation based on sperm tactic responses - use only one or two parameters and are not comparable with the multistep sperm selection processes naturally occurring within the FRT. Fertilization-competent sperm require a panel of molecules, including zona pellucida-binding proteins and ion channel proteins, that enable them to progress through the FRT to achieve fertilization. The optimal artificial sperm selection method will, therefore, probably need to use a multiparameter tool that incorporates the molecular signature of sperm with high fertilization potential, and their responses to external cues, within a microfluidic system that can replicate the physiological processes of the FRT in vitro.

Rheotaxis-based microfluidic device for selecting sperm from samples infected with a virus

OBJECTIVE

To investigate whether the presented rheotaxis-based microfluidic device could be used to separate spermatozoa from viruses (i.e., Zika) in the infected semen sample during the selection and washing process.

DESIGN

Quantitative and experimental study of the sperm washing/selection process through the microfluidic platform exploiting the positive rheotaxis of sperm.

SETTING

None.

PATIENT(S)

None.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Human sperm were purchased from a sperm bank. The raw semen sample was mixed with viruses and loaded into a microfluidic device. Experiments were performed with 2 different flow rates (0 and 25 μL/minute) to investigate the washing efficiency of the device in the sperm selection process. The sperm sample was collected after 45 minutes and analyzed to check whether the collected sample is free of any infections (viruses) after isolation.

RESULT(S)

Fluorescent microscopy and quantitative polymerase chain reaction-based analysis showed that the sperm selected with the presented rheotaxis-based microfluidic device at the optimal flow rate (25 μL/minute) was free of any viruses.

CONCLUSION(S)

We have developed a simple, cost-effective microfluidic device that mimics the conditions of the female genital tract while washing out the raw semen efficiently during the selection process for assisted reproductive technology.

Advancements in Microfluidic Systems for the Study of Female Reproductive Biology

The female reproductive tract is a highly complex physiological system that consists of the ovaries, fallopian tubes, uterus, cervix, and vagina. An enhanced understanding of the molecular, cellular, and genetic mechanisms of the tract will allow for the development of more effective assisted reproductive technologies, therapeutics, and screening strategies for female specific disorders. Traditional 2-dimensional and 3-dimensional static culture systems may not always reflect the cellular and physical contexts or physicochemical microenvironment necessary to understand the dynamic exchange that is crucial for the functioning of the reproductive system. Microfluidic systems present a unique opportunity to study the female reproductive tract, as these systems recapitulate the multicellular architecture, contacts between different tissues, and microenvironmental cues that largely influence cell structure, function, behavior, and growth. This review discusses examples, challenges, and benefits of using microfluidic systems to model ovaries, fallopian tubes, endometrium, and placenta. Additionally, this review also briefly discusses the use of these systems in studying the effects of endocrine disrupting chemicals and diseases such as ovarian cancer, preeclampsia, and polycystic ovarian syndrome.

Rheotaxis-based sperm separation using a biomimicry microfluidic device

Sperm selection is crucial to assisted reproduction, influencing the success rate of the treatment cycle and offspring health. However, in the current clinical sperm selection practices, bypassing almost all the natural selection barriers is a major concern. Here, we present a biomimicry microfluidic method, inspired by the anatomy of the female reproductive tract, that separates motile sperm based on their rheotaxis behavior to swim against the flow into low shear rate regions. The device includes micropocket geometries that recall the oval-shaped microstructures of the female fallopian tube to create shear protected zones for sperm separation. Clinical tests with human samples indicate that the device is capable of isolating viable and highly motile sperm based on their rheotaxis responses, resulting in a separation efficiency of 100%. The device presents an automated alternative for the current sperm selection practices in assisted reproduction.

A High-voltage TENG-based Droplet Energy Generator with Ultralow Liquid Consumption

A solid-liquid triboelectric nanogenerator (TENG) has attracted increasing research interest in relation to the development of regeneration energy based on water resources. The output of solid-liquid TENG remains unsolved, however, because of the low voltage output that impedes wide applications. To this end, in this work we developed a miniaturized microfluidic channel-based TENG device for highly efficient conversion of energy from the transport of a water droplet to an electrical output. We investigated an optimized design in a triboelectric material, the droplet transport and the electrostatic induction layer to provide a high voltage output and stable energy harvesting. The optimized device demonstrated maximum voltage amplitude 102 mV with an ultralow liquid consumption, 0.36 μL, resulting in sample-energy conversion 283.33 mV/μL. This novel device is expected potentially to address the limitations imposed by sample consumption in energy harvesting in the future.

Advances in sperm analysis: techniques, discoveries and applications

Infertility affects one in six couples worldwide, and fertility continues to deteriorate globally, partly owing to a decline in semen quality. Sperm analysis has a central role in diagnosing and treating male factor infertility. Many emerging techniques, such as digital holography, super-resolution microscopy and next-generation sequencing, have been developed that enable improved analysis of sperm motility, morphology and genetics to help overcome limitations in accuracy and consistency, and improve sperm selection for infertility treatment. These techniques have also improved our understanding of fundamental sperm physiology by enabling discoveries in sperm behaviour and molecular structures. Further progress in sperm analysis and integrating these techniques into laboratories and clinics requires multidisciplinary collaboration, which will increase discovery and improve clinical outcomes.

Progressive bovine sperm separation using parallelized microchamber-based microfluidics

Motility is one of the most important factors in sperm migration toward an egg. Therefore, sperm separation based on motility might enhance sperm selection for infertility treatments. Conventional centrifugation-based methods increase the risk of damage to sperm cells. Microfluidic systems, on the other hand, can sort sperm in a less intrusive way, but their efficiency and throughput still needs improvement, especially in low-concentration samples (oligozoospermia). Here, a microchamber-based microfluidic platform is demonstrated that can separate progressively motile sperm from non-viable sperm and debris, and trap nonprogressive sperm in microchambers. This platform can be operated in a short period of time (<10 min) with an excellent degree of controllability with no sample preparation. Sperm were screened in a 384-microchamber platform. The mean average-path velocity of the motile sperm in the collected sample increased significantly, from 57 ± 10 μm s^-1 in the raw semen sample to 81 ± 13 μm s^-1. The DNA Integrity of the separated sperm showed 20% improvement over the raw sample which indicated that separated sperm were of higher quality. We began with a 22.5 μL raw bovine sperm sample which had a concentration of 8.5 million sperm per milliliter (M mL^-1) with 38% motility. After separation, the concentration of the collected sperm was 2.1 M mL^-1 with a motility rate of 90%. This corresponds to a 75% retrieval efficiency and the selection of approximately 5.2 × 10⁴ progressively motile spermatozoa. Our results show that the microchamber depth does not affect the residence time of motile sperm; therefore, it is possible to inspect higher sample volumes within the same time frame. This microfluidic platform may provide an easy-to-implement solution for high-throughput, robust, and efficient, collection of progressive sperm with the DNA integrity needed for assisted reproductive technologies (ARTs). However, further studies are necessary to show the implications of this method in human cases.

Machine learning for sperm selection

Infertility rates and the number of couples seeking fertility care have increased worldwide over the past few decades. Over 2.5 million cycles of assisted reproductive technologies are being performed globally every year, but the success rate has remained at ~33%. Machine learning, an automated method of data analysis based on patterns and inference, is increasingly being deployed within the health-care sector to improve diagnostics and therapeutics. This technique is already aiding embryo selection in some fertility clinics, and has also been applied in research laboratories to improve sperm analysis and selection. Tremendous opportunities exist for machine learning to advance male fertility treatments. The fundamental challenge of sperm selection - selecting the most promising candidate from 10⁸ gametes - presents a challenge that is uniquely well-suited to the high-throughput capabilities of machine learning algorithms paired with modern data processing capabilities.

Selection of high-quality sperm with thousands of parallel channels

Sperm selection is essential for successful fertilization and embryo development. Current clinical sperm selection methods are labor-intensive and lack the selectivity required to isolate high-quality sperm. Microfluidic sperm selection approaches have shown promise but present a trade-off between the quality and quantity of selected sperm - clinicians demand both. The structure of the female reproductive tract helps to isolate a sufficient quantity of high-quality sperm for fertilization with densely folded epithelium that provides a multitude of longitudinally oriented pathways that guide sperm toward the fertilization site. Here, a three-dimensionally structured sperm selection device is presented that levers this highly parallelized in vivo mechanism for in vitro sperm selection. The device is inserted in a test tube atop 1 mL of raw semen and provides 6500 channels that isolate ∼100 000 high-DNA-integrity sperm for assisted reproduction. In side-by-side clinical testing, the developed approach outperforms the best current clinical methods by improving the DNA integrity of the selected sperm subpopulation up to 95%. Also, the device streamlines clinical workflow, reducing the time required for sperm preparation 3-fold. This single-tube, single-step sperm preparation approach promises to improve both the economics and outcomes of assisted reproduction practices, especially in cases with significant male-factors.

Curvature in the reproductive tract alters sperm-surface interactions

The fallopian tube is lined with a highly complex folded epithelium surrounding a lumen that progressively narrows. To study the influence of this labyrinthine complexity on sperm behavior, we use droplet microfluidics to create soft curved interfaces over a range of curvatures corresponding to the in vivo environment. We reveal a dynamic response mechanism in sperm, switching from a progressive surface-aligned motility mode at low curvatures (larger droplets), to an aggressive surface-attacking mode at high curvatures (smaller droplets of <50 µm-radius). We show that sperm in the attacking mode swim ~33% slower, spend 1.66-fold longer at the interface and have a 66% lower beating amplitude than in the progressive mode. These findings demonstrate that surface curvature within the fallopian tube alters sperm motion from a faster surface aligned locomotion in distal regions to a prolonged physical contact with the epithelium near the site of fertilization, the latter being known to promote capacitation and fertilization competence.

Recent Microfluidic Innovations for Sperm Sorting

Sperm selection is a clinical need for guided fertilization in men with low-quality semen. In this regard, microfluidics can provide an enabling platform for the precise manipulation and separation of high-quality sperm cells through applying various stimuli, including chemical agents, mechanical forces, and thermal gradients. In addition, microfluidic platforms can help to guide sperms and oocytes for controlled in vitro fertilization or sperm sorting using both passive and active methods. Herein, we present a detailed review of the use of various microfluidic methods for sorting and categorizing sperms for different applications. The advantages and disadvantages of each method are further discussed and future perspectives in the field are given.

Toward embryo cryopreservation-on-a-chip: A standalone microfluidic platform for gradual loading of cryoprotectants to minimize cryoinjuries

Embryo vitrification is a fundamental practice in assisted reproduction and fertility preservation. A key step of this process is replacing the internal water with cryoprotectants (CPAs) by transferring embryos from an isotonic to a hypertonic solution of CPAs. However, this applies an abrupt osmotic shock to embryos, resulting in molecular damages that have long been a source of concern. In this study, we introduce a standalone microfluidic system to automate the manual process and minimize the osmotic shock applied to embryos. This device provides the same final CPA concentrations as the manual method but with a gradual increase over time instead of sudden increases. Our system allows the introduction of the dehydrating non-permeating CPA, sucrose, from the onset of CPA-water exchange, which in turn reduced the required time of CPA loading for successful vitrification without compromising its outcomes. We compared the efficacy of our device and the conventional manual procedure by studying vitrified-warmed mouse blastocysts based on their re-expansion and hatching rates and transcription pattern of selected genes involved in endoplasmic reticulum stress, oxidative stress, heat shock, and apoptosis. While both groups of embryos showed comparable re-expansion and hatching rates, on-chip loading reduced the detrimental gene expression of cryopreservation. The device developed here allowed us to automate the CPA loading process and push the boundaries of cryopreservation by minimizing its osmotic stress, shortening the overall process, and reducing its molecular footprint.

A microfluidic approach to rapid sperm recovery from heterogeneous cell suspensions

The isolation of sperm cells from background cell populations and debris is an essential step in all assisted reproductive technologies. Conventional techniques for sperm recovery from testicular sperm extractions stagnate at the sample processing stage, where it can take several hours to identify viable sperm from a background of collateral cells such as white bloods cells (WBCs), red blood cells (RBCs), epithelial cells (ECs) and in some cases cancer cells. Manual identification of sperm from contaminating cells and debris is a tedious and time-consuming operation that can be suitably addressed through inertial microfluidics. Microfluidics has proven an effective technology for high-quality sperm selection based on motility. However, motility-based selection methods cannot cater for viable, non-motile sperm often present in testicular or epididymal sperm extractions and aspirations. This study demonstrates the use of a 3D printed inertial microfluidic device for the separation of sperm cells from a mixed suspension of WBCs, RBCs, ECs, and leukemic cancer cells. This technology presents a 36-fold time improvement for the recovery of sperm cells (> 96%) by separating sperm, RBCS, WBCs, ECs and cancer cells into tight bands in less than 5 min. Furthermore, microfluidic processing of sperm has no impact on sperm parameters; vitality, motility, morphology, or DNA fragmentation of sperm. Applying inertial microfluidics for non-motile sperm recovery can greatly improve the current processing procedure of testicular sperm extractions, simplifying the fertility outcomes for severe forms of male infertility that warrant the surgery.

A new open-source hardware device to measure vertical sperm motility and concentration

Sperm motility and concentration are commonly evaluated parameters in semen analysis. Those parameters are assessed objectively with commercial instrumentation such as computer-assisted sperm analysis systems (CASA) and hemocytometer. In CASA systems, sperm motility is assessed in the horizontal plane imposed by the stage of the microscope. Thus, there is lack of measurement of the vertical velocity of sperm. The female reproductive tract is a tridimensional space which the sperm traverse to reach the ovum, and there is a need for instruments measuring parameters more relevant to this real-world situation. In this report we describe the design, construction and use of an open-source hardware (OSH) device for evaluation of the vertical velocity of sperm, called UPSPERM. This device was also used to measure sperm concentration, and agreement with hemocytometer was evaluated. Bland-Altman analysis shows good agreement between these two methods of sperm counting. As a first application of UPSPERM, we evaluated the changes in boar sperm motility at distinct pH values between 7.0 and 8.0. The UPSPERM results showed that the vertical velocity of sperm was highest at pH 7.6 and 7.8. We propose that our UPSPERM offers a reliable and affordable option for obtaining measurements of vertical velocity and sperm concentration.

FertDish: microfluidic sperm selection-in-a-dish for intracytoplasmic sperm injection

The selection of high quality sperm is critical for intracytoplasmic sperm injection (ICSI), a prevalent assisted reproduction technology. However, standard selection methods are time-consuming and fail to recover the most viable sperm, thereby limiting the ICSI success rate. Microfluidics enables rapid selection of viable sperm in a manner representing in vivo processes, however, existing platforms lack clinical applicability. Here, we present FertDish, which integrates the clinically established ICSI Petri dish with a film featuring an array of sperm-selecting microchannels for selection of sperm directly from semen. The FertDish format mimics the clinician-familiar ICSI dish setup, and provides rapid (<10 min) single stage sperm preparation that circumvents standard labour-intensive multi-stage sperm processing steps. Tests with human donor and patient semen samples show that FertDish enables the selection of a high quality sperm sub-population, featuring improvements in DNA fragmentation index of more than 91% (donor) and 74% (patient) versus raw semen and 50% (donor) and 63% (patient) versus standard methods, and a distribution of more than 97% sperm with viable and high level DNA. The FertDish enables a high sperm recovery rate (>3.3 × 105 sperm per mL), and is readily adaptable to the clinical workflow with potential to improve ICSI outcomes.

A fully integrated biomimetic microfluidic device for evaluation of sperm response to thermotaxis and chemotaxis

In recent decades, humans have faced greater challenges in reproduction. Assisted reproductive technology is the most prominent approach for addressing this problem. Current clinical screening methods simply consider the motility or morphology of the sperm. However, as the spermatozoa need to navigate over a long distance in the female reproductive tract and survive the natural screening processes therein, these methods are imperfect. Many approaches have been undertaken to study the chemotaxis and thermotaxis navigation behavior of spermatozoa, but few of these have involved integrated screening that considers motility, chemotaxis, and thermotaxis based on the biological environment of the human body. Current routine sperm evaluation techniques are inadequate and fail to simultaneously provide conclusive evidence for the thermotactic and chemotactic characteristics of sperm. Thus, such screening of functional spermatozoa will be an advancement in assisted reproduction. In this study, we developed a fully integrated biomimetic microfluidic system for screening sperm for their characteristics when exposed to temperature and chemical gradients. Based on our results, we showed that spermatozoa were attracted by temperature and chemical gradients in the physiological range. Moreover, we ascertained a suitable temperature gradient range for thermotaxis and statistically proved that the thermotactic and chemotactic responses are not linked. Here, we report the first quantitative study of functional sperm during thermotaxis and chemotaxis, and our analysis of the difference in motility caused by different conditions. More broadly, we foresee the clinical application of these biologically motivated parameters and characteristics in assisted reproduction in humans.

Advanced bioengineering of male germ stem cells to preserve fertility

In modern life, several factors such as genetics, exposure to toxins, and aging have resulted in significant levels of male infertility, estimated to be approximately 18% worldwide. In response, substantial progress has been made to improve in vitro fertilization treatments (e.g. microsurgical testicular sperm extraction (m-TESE), intra-cytoplasmic sperm injection (ICSI), and round spermatid injection (ROSI)). Mimicking the structure of testicular natural extracellular matrices (ECM) outside of the body is one clear route toward complete in vitro spermatogenesis and male fertility preservation. Here, a new wave of technological innovations is underway applying regenerative medicine strategies to cell-tissue culture on natural or synthetic scaffolds supplemented with bioactive factors. The emergence of advanced bioengineered systems suggests new hope for male fertility preservation through development of functional male germ cells. To date, few studies aimed at in vitro spermatogenesis have resulted in relevant numbers of mature gametes. However, a substantial body of knowledge on conditions that are required to maintain and mature male germ cells in vitro is now in place. This review focuses on advanced bioengineering methods such as microfluidic systems, bio-fabricated scaffolds, and 3D organ culture applied to the germline for fertility preservation through in vitro spermatogenesis.

Increasing the packing density of assays in paper-based microfluidic devices

Paper-based devices have a wide range of applications in point-of-care diagnostics, environmental analysis, and food monitoring. Paper-based devices can be deployed to resource-limited countries and remote settings in developed countries. Paper-based point-of-care devices can provide access to diagnostic assays without significant user training to perform the tests accurately and timely. The market penetration of paper-based assays requires decreased device fabrication costs, including larger packing density of assays (i.e., closely packed features) and minimization of assay reagents. In this review, we discuss fabrication methods that allow for increasing packing density and generating closely packed features in paper-based devices. To ensure that the paper-based device is low-cost, advanced fabrication methods have been developed for the mass production of closely packed assays. These emerging methods will enable minimizing the volume of required samples (e.g., liquid biopsies) and reagents in paper-based microfluidic devices.

Comparison of commercially available chamber slides for computer-aided analysis of human sperm

Despite the increasing use of computer-aided sperm analysis (CASA) in clinical practice, there is still no golden standard for the type of slide to be used with these systems. Counting chamber depth and loading method, can profoundly influence motility and concentration estimates, thereby undermining the validity and accuracy of CASA. To contribute toward standardized sperm analysis, this study compared different commercially available capillary-filled slides including 10 and 20 µm deep Leja slides (Leja10 and Leja20); 10, 16 and 20 µm deep CellVision slides (CV10, CV16 and CV20); and drop-loaded slides including slide and coverslip (SCS) with a depth of 20.1 µm and the Makler chamber with a depth of 10 µm for sperm analysis when using CASA. The Sperm Class Analyzer (SCA) CASA system was used to assess concentration, motility, and detailed kinematic parameters of 20 normozoospermic human samples using the different chamber slides. Results were evaluated by the repeated measures ANOVA and Intraclass correlation coefficients. The Makler chamber showed significantly (P < 0.05) higher concentrations than other slides. However, there was no significant difference in the percentage of sperm in different motility groups among the slides. CV10, Leja10 and Makler showed significantly higher curvilinear-, average path- and straight-line velocity (VCL, VAP, VSL) values than other slides. In conclusion, despite the objectiveness of the assessments by CASA systems, there are still some discrepancies in the results of sperm concentration, motility and other kinematic parameters when using different commercially available slides. The possible negative influence of the sperm quality misdiagnosis on the selection of treatment strategy in a clinical setting, emphasizes the need for further standardization and quality control of the commercially available chamber slides for use with CASA. Furthermore, this study found more consistent results for capillary-filled chambers compared to drop-loaded slides, suggesting a superior method when using CASA.Abbreviations: DNA: Deoxyribonucleic acid; CASA: Computer-aided semen analysis; SCA: Sperm Class Analyzer; WHO: World Health Organization; CV: CellVision; SCS: Slide and Coverslip; SD: Standard deviation; ANOVA: Analysis of Variance; PR: Progressive; NP: Non-progressive; IMT: Immotile; VCL: Curvilinear velocity; VAP: Average path velocity; VSL: Straight-line velocity; Lin: Linearity; STR: Straightness; WOB: Wobble; ALH: Amplitude of lateral head displacement; BCF: Beat cross frequency.

Web- and Artificial Intelligence-Based Image Recognition For Sperm Motility Analysis: Verification Study

Background

Human sperm quality fluctuates over time. Therefore, it is crucial for couples preparing for natural pregnancy to monitor sperm motility.

Objective

This study verified the performance of an artificial intelligence–based image recognition and cloud computing sperm motility testing system (Bemaner, Createcare) composed of microscope and microfluidic modules and designed to adapt to different types of smartphones.

Methods

Sperm videos were captured and uploaded to the cloud with an app. Analysis of sperm motility was performed by an artificial intelligence–based image recognition algorithm then results were displayed. According to the number of motile sperm in the vision field, 47 (deidentified) videos of sperm were scored using 6 grades (0-5) by a male-fertility expert with 10 years of experience. Pearson product-moment correlation was calculated between the grades and the results (concentration of total sperm, concentration of motile sperm, and motility percentage) computed by the system.

Results

Good correlation was demonstrated between the grades and results computed by the system for concentration of total sperm (r=0.65, P<.001), concentration of motile sperm (r=0.84, P<.001), and motility percentage (r=0.90, P<.001).

Conclusions

This smartphone-based sperm motility test (Bemaner) accurately measures motility-related parameters and could potentially be applied toward the following fields: male infertility detection, sperm quality test during preparation for pregnancy, and infertility treatment monitoring. With frequent at-home testing, more data can be collected to help make clinical decisions and to conduct epidemiological research.

High DNA integrity sperm selection using surface acoustic waves

Male infertility is a global reproductive issue, several clinical approaches have been developed to tackle it, but their effectiveness is limited by the labour-intensive and time-consuming sperm selection procedures used. Here, we present an automated, acoustic based continuous-flow method capable of selecting high quality sperm with considerably improved motility and DNA integrity compared to the initial raw bull semen. The acoustic field translates larger sperm and guides highly motile sperm across the channel width. The result is the selection of sperm with over 50% and 60% improvement in vitality and progressive motility and more than 38% improvement in DNA integrity, respectively, while providing a clinically relevant volume and selected sperm number for the performance of in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) by selecting over 60 000 sperm in under an hour.

Medical Micro/Nanorobots in Precision Medicine

Advances in medical robots promise to improve modern medicine and the quality of life. Miniaturization of these robotic platforms has led to numerous applications that leverages precision medicine. In this review, the current trends of medical micro and nanorobotics for therapy, surgery, diagnosis, and medical imaging are discussed. The use of micro and nanorobots in precision medicine still faces technical, regulatory, and market challenges for their widespread use in clinical settings. Nevertheless, recent translations from proof of concept to in vivo studies demonstrate their potential toward precision medicine.

Quantification of human sperm concentration using machine learning-based spectrophotometry

Spectrophotometry is an indirect non-invasive and quantitative method for specifying materials with unknown contents based on absorption behavior. This paper presents the first application of artificial neural network in spectrophotometry for quantification of human sperm concentration. A well-trained full spectrum neural network (FSNN) model is developed by examining the absorption response of sperm samples from 41 human subjects to different light spectra (wavelength from 390 to 1100 nm). It is shown that this FSNN accurately estimates sperm concentration based on the full absorption spectrum with over 93% prediction accuracy, and provides 100% agreement with clinical assessments in differentiating the samples of healthy donor from patient samples. We suggest the machine learning-based spectrophotometry approach with the trained FSNN model as a rapid, low-cost, and powerful technique to quantify sperm concentration. The performance of this technique is superior to available spectrophotometry methods currently used for semen analysis and will provide novel research and clinical opportunities for tackling male infertility.

Narrow-escape time and sorting of active particles in circular domains

It is now well established that microswimmers can be sorted or segregated fabricating suitable microfluidic devices or using external fields. A natural question is how these techniques can be employed for dividing swimmers of different motility. In this paper, using numerical simulations in the dilute limit, we investigate how motility parameters (time of persistence and velocity) impact the narrow-escape time of active particles from circular domains. We show that the escape time undergoes a crossover between two asymptotic regimes. The control parameters of the crossover is the ratio between the persistence length of the active motion and the typical length scale of the circular domain. We explore the possibility of taking advantage of this finding for sorting active particles by motility parameters.

The Microfluidic Trainer: Design, Fabrication and Validation of a Tool for Testing and Improving Manual Skills

Microfluidic principles have been widely applied for more than 30 years to solve biological and micro-electromechanical problems. Despite the numerous advantages, microfluidic devices are difficult to manage as their handling comes with several technical challenges. We developed a new portable tool, the microfluidic trainer (MT), that assesses the operator handling skills and that may be used for maintaining or improving the ability to inject fluid in the inlet of microfluidic devices for in vitro cell culture applications. After several tests, we optimized the MT tester cell to reproduce the real technical challenges of a microfluidic device. In addition to an exercise path, we included an overfilling indicator and a correct infilling indicator at the inlet (control path). We manufactured the MT by engraving a 3 mm-high sheet of methacrylate with 60W CO₂ laser plotter to create multiple capillary paths. We validated the device by enrolling 21 volunteers (median age 33) to fill both the MT and a commercial microfluidic device. The success rate obtained with MT significantly correlated with those of a commercial microfluidic culture plate, and its 30 min-continuous use for three times significantly improved the performance. Overall, our data demonstrate that MT is a valid assessment tool of individual performances in using microfluidic devices and may represent a low-cost solution to training, improve or warm up microfluidic handling skills.

Effect of microfluidic processing on the viability of boar and bull spermatozoa

The use of microfluidics in artificial reproductive technologies for manipulation or assessment of spermatozoa is unique in the sense that it is not always an end point measurement and the sample may be used afterward. During microfluidic processing, spermatozoa are exposed to shear stress, which may harm viability and functioning of spermatozoa. The shear stresses during general microfluidic processing steps were calculated and compared to estimated shear stresses during ejaculation. The viability of boar and bull spermatozoa after microfluidic processing was studied and compared to the typical handling method (centrifugation) and to a control (the sample in a tube at the same temperature). The boar spermatozoa showed a small but significant decrease in viability of 6% after microfluidic handling. Bull spermatozoa proved to be less susceptible to shear stress and were not significantly affected by microfluidic processing. These data indicate that the impact of microfluidic processing on the viability of boar and bull spermatozoa is less than the literature values reported for flow cytometry and comparable to the impact of centrifugation.

Self-organization and multi-line transport of human spermatozoa in rectangular microchannels due to cell-cell interactions

The journey of sperm navigation towards ovum is one of the most important questions in mammalian fertilisation and reproduction. However, we know very little about spermatozoa propagation in a complex fluidic, chemical and topographic environment of a fertility tract. Using microfluidics techniques, we investigate the influence of cell-cell interactions on spermatozoa swimming behavior in constrained environment at different concentrations. Our study shows that at high enough cell concentration the interaction between boundary-following cells leads to formation of areas with preferential direction of cell swimming. In the microchannel of a rectangular cross-section, this leads to formation of a “four-lane” swimming pattern with the asymmetry of the cell distribution of up to 40%. We propose that this is caused by the combination of cell-cell collisions in the corners of the microchannel and the existence of morphologically different spermatozoa: slightly asymmetric cells with trajectories curved left and the symmetric ones, with trajectories curved right. Our findings suggest that cell-cell interactions in highly folded environment of mammalian reproductive tract are important for spermatozoa swimming behavior and play role in selection of highly motile cells.

High Sperm DNA Damage: Does Testicular Sperm Make Sense?

Sperm DNA damage reduces pregnancy rates in couples undergoing in vitro fertilization (IVF). Because it has been shown that testicular sperm have lower DNA damage than ejaculated sperm, it is an attractive idea to consider using testicular sperm for IVF for men with high sperm DNA damage. In fact, there are multiple centers throughout the world now offering sperm retrieval for IVF to manage this condition. However, there is insufficient evidence to conclude that testicular sperm improves pregnancy/live birth rates. Further studies are required before offering sperm retrieval as a standard of care to manage high sperm DNA damage.

Male Infertility and the Future of In Vitro Fertilization

The male contribution to infertility has traditionally been overlooked, or at best oversimplified. In recent years efforts have been made to optimize diagnostic and therapeutic techniques to maximize fertility outcomes. A renewed focus on the male partner has resulted in an increased understanding of both genetic and epigenetic changes within the male germline. Furthermore, single-nucleotide polymorphisms, copy-number variants, DNA damage, sperm cryopreservation, obesity, and paternal age have recently been recognized as important factors that play a role in male fertility. Developing a deeper knowledge of these issues could potentially lead to improved success with assisted reproductive technology.

Hitting the wall: Human sperm velocity recovery under ultra-confined conditions

Infertility is a common medical condition encountered by health systems throughout the world. Despite the development of complex in vitro fertilization techniques, only one-third of these procedures are successful. New lab-on-a-chip systems that focus on spermatozoa selection require a better understanding of sperm behavior under ultra-confined conditions in order to improve outcomes. Experimental studies combined with models and simulations allow the evaluation of the efficiency of different lab-on-a-chip devices during the design process. In this work, we provide experimental evidence of the dynamics of sperm interacting with a lateral wall in a shallow chamber. We observe a decrease in average sperm velocity during initial wall interaction and partial recovery after the alignment of the trajectory of the cell. To describe this phenomenon, we propose a simple model for the sperm alignment process with a single free parameter. By incorporating experimental motility characterization into the model, we achieve an accurate description of the average velocity behavior of the sperm population close to walls. These results will contribute to the design of more efficient lab-on-a-chip devices for the treatment of human infertility.

Microfluidic retention of progressively motile zebrafish sperms

Genetic manipulation of zebrafish results in thousands of mutant strains and to efficiently preserve them for future use, zebrafish sperms have been cryopreserved in various cryopreservation centers. However, cryopreservation protocols are known to alter genetic entities. Therefore, there is an urgent need for an efficient method that can select morphologically superior and progressively motile zebrafish sperms after their activation for in vitro fertilization success. However, unlike those of other mammalian species, fish sperms do not take any physical or chemical cues to travel towards the egg. Their inertness towards any external cues makes the control of their orientation in a microfluidic environment difficult. In this aspect, a new microfluidic concept was demonstrated where PDMS baffles were inserted in the sidewalls to form microscale confinement creating a flow stagnation zone towards sperm retention. Two distinct microfluidic device designs were selected to evidence the improvement in sperm retention through the unique hydrodynamic feature provided by the microchannel design. Under similar flow conditions, 44% improvement was noticed for the device with a modified baffle design in terms of sperm retrieving efficiency. It was further noticed that with a flow tuning of 0.7 μL min^-1, 80% of the total sperms swimming into the retention zones was retained within a specific time window. The present work further explains the significance of the hydrodynamic dependency of zebrafish sperm kinematics that paves the way for highly efficient spermatozoan manipulation.

Microfluidics-Based Biomaterials and Biodevices

The rapid development of microfluidics technology has promoted new innovations in materials science, particularly by interacting with biological systems, based on precise manipulation of fluids and cells within microscale confinements. This article reviews the latest advances in microfluidics-based biomaterials and biodevices, highlighting some burgeoning areas such as functional biomaterials, cell manipulations, and flexible biodevices. These areas are interconnected not only in their basic principles, in that they all employ microfluidics to control the makeup and morphology of materials, but also unify at the ultimate goals in human healthcare. The challenges and future development trends in biological application are also presented.

A treatment approach for couples with disrupted sperm DNA integrity and recurrent ART failure

OBJECTIVE

To test a novel method to select spermatozoa with high chromatin integrity.

DESIGN

Specimens with high sperm chromatin fragmentation (SCF) were selected by density gradient selection (DGS) and microfluidic sperm sorting (MSS).

SETTING

Academic medical center.

PATIENT(S)

Ejaculates from consenting men were processed by DGS/MSS. Couples underwent ICSI cycles with spermatozoa processed by DGS/MSS. Clinical outcomes were evaluated after embryo transfer.

INTERVENTION(S)

SCF was measured by TUNEL. ICSI with spermatozoa selected by DGS and MSS was performed.

MAIN OUTCOME MEASURE(S)

Fertilization, embryo implantation, and pregnancy outcomes were compared between DGS and MSS.

RESULT(S)

A total of 23 men had an average SCF of 20.7 ± 10%. After DGS and MSS, the SCF was 12.5 ± 5% and 1.8 ± 1%, respectively. In couples who underwent ICSI, the average SCF was 28.8 ± 9%, which fell to 21.0 ± 9% after DGS and 1.3 ± 0.7% after MSS. Four couples underwent 11 ICSI cycles with DGS and achieved one (25%) pregnancy that resulted in pregnancy loss. In four subsequent ICSI cycles with MSS, an ongoing clinical pregnancy rate of 50% was achieved. Five additional couples underwent 12 cycles of ICSI with DGS. After preimplantation genetic testing for aneuploidy, 30.3% of the embryos were euploid. One pregnancy was achieved, resulting in pregnancy loss. With MSS, 31.5% of the embryos were euploid and 4 couples obtained a pregnancy. Finally, sixteen couples underwent 20 ICSI cycles solely with MSS at our center. Of these couples, 8 had failed 13 ICSI cycles with DGS elsewhere. These couples achieved an overall implantation of 34.5% (10/29) and a pregnancy rate of 58.8% (10/17).

CONCLUSION(S)

Microfluidic selection yielded spermatozoa with optimal genomic integrity and improved chances of obtaining a euploid conceptus.