Advances in microfluidic technology for sperm screening and in vitro fertilization

About 18% of reproductive-age adults worldwide are affected by infertility. In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are widely used assisted reproductive technologies (ARTs) aimed at improving clinical outcomes. Efficient and noninvasive selection and isolation of highly motile sperm with intact DNA are essential for the success of IVF and ICSI and can potentially impact the therapeutic efficacy and the health of the offspring. Compared to traditional methods, microfluidic technology offers significant advantages such as low sample consumption, high efficiency, minimal damage, high integration, similar microenvironment, and high automation, providing a new platform for ARTs. Here, we review the current situation of microfluidic technology in the field of sperm motility screening and evaluation and IVF research. First, we focus on the working principle, structural design, and screening results of sperm selection microfluidic platforms. We then highlight how the multiple steps of the IVF process can be facilitated and integrated into a microfluidic chip, including oocyte capture, sperm collection and isolation, sperm sorting, fertilization, and embryo culture. Ultimately, we summarize how microfluidics can complement and optimize current sperm sorting and IVF protocols, and challenges and possible solutions are discussed.

Microfluidics as an emerging paradigm for assisted reproductive technology: A sperm separation perspective

Millions of people are subject to infertility worldwide and one in every six people, regardless of gender, experiences infertility at some period in their life, according to the World Health Organization. Assisted reproductive technologies are defined as a set of procedures that can address the infertility issue among couples, culminating in the alleviation of the condition. However, the costly conventional procedures of assisted reproduction and the inherent vagaries of the processes involved represent a setback for its successful implementation. Microfluidics, an emerging tool for processing low-volume samples, have recently started to play a role in infertility diagnosis and treatment. Given its host of benefits, including manipulating cells at the microscale, repeatability, automation, and superior biocompatibility, microfluidics have been adopted for various procedures in assisted reproduction, ranging from sperm sorting and analysis to more advanced processes such as IVF-on-a-chip. In this review, we try to adopt a more holistic approach and cover different uses of microfluidics for a variety of applications, specifically aimed at sperm separation and analysis. We present various sperm separation microfluidic techniques, categorized as natural and non-natural methods. A few of the recent developments in on-chip fertilization are also discussed.

Micro/Nanorobotics in In Vitro Fertilization: A Paradigm Shift in Assisted Reproductive Technologies

In vitro fertilization (IVF) has transformed the sector of assisted reproductive technology (ART) by presenting hope to couples facing infertility challenges. However, conventional IVF strategies include their own set of problems such as success rates, invasive procedures, and ethical issues. The integration of micro/nanorobotics into IVF provides a prospect to address these challenging issues. This article provides an outline of the use of micro/nanorobotics in IVF specializing in advancing sperm manipulation, egg retrieval, embryo culture, and capacity future improvements in this swiftly evolving discipline. The article additionally explores the challenges and obstacles associated with the integration of micro/nanorobotics into IVF, in addition to the ethical concerns and regulatory elements related to the usage of advanced technologies in ART. A comprehensive discussion of the risk and safety considerations related to using micro/nanorobotics in IVF techniques is likewise presented. Through this exploration, we delve into the core principles, benefits, challenges, and potential impact of micro/nanorobotics in revolutionizing IVF procedures and enhancing affected person outcomes.

Qualified sperm selection based on the rheotaxis and thigmotaxis in a microfluidic system

Microfluidic systems with the ability to mimic the female reproductive tract (FRT) and sperm features have emerged as promising methods to separate sperm with higher quality for the assistant reproductive technology. Thereby, we designed and fabricated a microfluidic system based on FRT features with a focus on rheotaxis and thigmotaxis for passive sperm separation. In this regard, four various geometries (linear, square, zigzag, and sinusoidal) were designed, and the effect of rheotaxis and thigmotaxis were investigated. Although separated sperm in all microchannels were 100% motile, non-linear geometries were more effective than linear geometry in the term of separating the progressive sperm with high quality. In the presence of upstream flow, periodical changes in the slope of walls (in non-linear geometries) give rise to the periodical facing sperm with a high flow rate in the middle of microchannels, which was a reason for the high quality of separated sperm. However, because of sharp corners in the square and zigzag microchannels that create dead zones with a lack of upstream flow, which is noticeable via simulation results, these geometries have obstacles against sperm swimming toward the outlet, which was proved by image analysis. The sinusoidal geometry showed the highest enhancement level of the designed geometries compared to the linear geometry. Separated sperm exhibited 34.7% normal morphology, 100% motility, and 100% viability in the sinusoidal geometry. Therefore, the periodic change in the position of sperm from one wall to another wall can be a strategy for separating sperm with high quality.

Graphical abstract

In the present study, we used a microfluidic system for studying the combined effects of thigmotaxis and rheotaxis for sperm separation process to achieve the successful Assisted reproductive technology (ART). The designed PDMS-based microfluidic system had four various geometries, including linear, square, zigzag, and sinusoidal. The functionality of separated sperm was evaluated by sperm tracking (ImageJ), motility assay (CASA software), and morphology assay (Papanicolaou ultrafast staining). Probing various geometries revealed 100% motility. In non-linear geometries, sperm's periodic detachment from the walls gave rise to the periodic interaction with the high flow velocity in the center of the channel, resulting in the separation of high-quality sperm with progressive motility. The collected data proved the influence of thigmotaxis on the quality of separated sperm. Morphologically improvement in separated sperm from the sinusoidal geometry was significant than others, which means the sinusoidal structure would be the best candidate for the sperm separation process.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13534-023-00294-8.

Recent Progress of Droplet Microfluidic Emulsification Based Synthesis of Functional Microparticles

The remarkable control function over the functional material formation process enabled by droplet microfluidic emulsification approaches can lead to the efficient and one-step encapsulation of active substances in microparticles, with the microparticle characteristics well regulated. In comparison to the conventional fabrication methods, droplet microfluidic technology can not only construct microparticles with various shapes, but also provide excellent templates, which enrich and expand the application fields of microparticles. For instance, intersection with disciplines in pharmacy, life sciences, and others, modifying the structure of microspheres and appending functional materials can be completed in the preparation of microparticles. The as-prepared polymer particles have great potential in a wide range of applications for chemical analysis, heavy metal adsorption, and detection. This review systematically introduces the devices and basic principles of particle preparation using droplet microfluidic technology and discusses the research of functional microparticle formation with high monodispersity, involving a plethora of types including spherical, nonspherical, and Janus type, as well as core-shell, hole-shell, and controllable multicompartment particles. Moreover, this review paper also exhibits a critical analysis of the current status and existing challenges, and outlook of the future development in the emerging fields has been discussed.

A Modified-Herringbone Micromixer for Assessing Zebrafish Sperm (MAGS)

Sperm motility analysis of aquatic model species is important yet challenging due to the small sample volume, the necessity to activate with water, and the short duration of motility. To achieve standardization of sperm activation, microfluidic mixers have shown improved reproducibility over activation by hand, but challenges remain in optimizing and simplifying the use of these microdevices for greater adoption. The device described herein incorporates a novel micromixer geometry that aligns two sperm inlet streams with modified herringbone structures that split and recombine the sample at a 1:6 dilution with water to achieve rapid and consistent initiation of motility. The polydimethylsiloxane (PDMS) chip can be operated in a positive or negative pressure configuration, allowing a simple micropipettor to draw samples into the chip and rapidly stop the flow. The device was optimized to not only activate zebrafish sperm but also enables practical use with standard computer-assisted sperm analysis (CASA) systems. The micromixer geometry could be modified for other aquatic species with differing cell sizes and adopted for an open hardware approach using 3D resin printing where users could revise, fabricate, and share designs to improve standardization and reproducibility across laboratories and repositories.

Sensors-integrated organ-on-a-chip for biomedical applications

As a promising new micro-physiological system, organ-on-a-chip has been widely utilized for in vitro pharmaceutical study and tissues engineering based on the three-dimensional constructions of tissues/organs and delicate replication of in vivo-like microenvironment. To better observe the biological processes, a variety of sensors have been integrated to realize in-situ, real-time, and sensitive monitoring of critical signals for organs development and disease modeling. Herein, we discuss the recent research advances made with respect to sensors-integrated organ-on-a-chip in this overall review. Firstly, we briefly explore the underlying fabrication procedures of sensors within microfluidic platforms and several classifications of sensory principles. Then, emphasis is put on the highlighted applications of different types of organ-on-a-chip incorporated with various sensors. Last but not least, perspective on the remaining challenges and future development of sensors-integrated organ-on-a-chip are presented.

Biomaterials for Testicular Bioengineering: How far have we come and where do we have to go?

Traditional therapeutic interventions aim to restore male fertile potential or preserve sperm viability in severe cases, such as semen cryopreservation, testicular tissue, germ cell transplantation and testicular graft. However, these techniques demonstrate several methodological, clinical, and biological limitations, that impact in their results. In this scenario, reproductive medicine has sought biotechnological alternatives applied for infertility treatment, or to improve gamete preservation and thus increase reproductive rates in vitro and in vivo. One of the main approaches employed is the biomimetic testicular tissue reconstruction, which uses tissue-engineering principles and methodologies. This strategy pursues to mimic the testicular microenvironment, simulating physiological conditions. Such approach allows male gametes maintenance in culture or produce viable grafts that can be transplanted and restore reproductive functions. In this context, the application of several biomaterials have been proposed to be used in artificial biological systems. From synthetic polymers to decellularized matrixes, each biomaterial has advantages and disadvantages regarding its application in cell culture and tissue reconstruction. Therefore, the present review aims to list the progress that has been made and the continued challenges facing testicular regenerative medicine and the preservation of male reproductive capacity, based on the development of tissue bioengineering approaches for testicular tissue microenvironment reconstruction.

Microfluidic solutions for biofluids handling in on-skin wearable systems

On-skin wearable systems for biofluid sampling and biomarker sensing can revolutionize the current practices in healthcare monitoring and personalized medicine. However, there is still a long path toward complete market adoption and acceptance of this fascinating technology. Accordingly, microfluidic science and technology can provide excellent solutions for bridging the gap between basic research and clinical research. The research gap has led to the emerging field of epidermal microfluidics. Moreover, recent advances in the fabrication of highly flexible and stretchable microfluidic systems have revived the concept of micro elastofluidics, which can provide viable solutions for on-skin wearable biofluid handling. In this context, this review highlights the current state-of-the-art platforms in this field and discusses the potential technologies that can be used for on-skin wearable devices. Toward this aim, we first compare various microfluidic platforms that could be used for on-skin wearable devices. These platforms include semiconductor-based, polymer-based, liquid metal-based, paper-based, and textile-based microfluidics. Next, we discuss how these platforms can enhance the stretchability of on-skin wearable biosensors at the device level. Next, potential microfluidic solutions for collecting, transporting, and controlling the biofluids are discussed. The application of finger-powered micropumps as a viable solution for precise and on-demand biofluid pumping is highlighted. Finally, we present the future directions of this field by emphasizing the applications of droplet-based microfluidics, stretchable continuous-flow micro elastofluidics, stretchable superhydrophobic surfaces, liquid beads as a form of digital micro elastofluidics, and topological liquid diodes that received less attention but have enormous potential to be integrated into on-skin wearable devices.

Microfluidic techniques for mechanical measurements of biological samples

The use of microfluidics to make mechanical property measurements is increasingly common. Fabrication of microfluidic devices has enabled various types of flow control and sensor integration at micrometer length scales to interrogate biological materials. For rheological measurements of biofluids, the small length scales are well suited to reach high rates, and measurements can be made on droplet-sized samples. The control of flow fields, constrictions, and external fields can be used in microfluidics to make mechanical measurements of individual bioparticle properties, often at high sampling rates for high-throughput measurements. Microfluidics also enables the measurement of bio-surfaces, such as the elasticity and permeability properties of layers of cells cultured in microfluidic devices. Recent progress on these topics is reviewed, and future directions are discussed.

A Federated Blockchain Approach for Fertility Preservation and Assisted Reproduction in Smart Cities

Modern life is making people infertile. Giving birth later in life is wreaking havoc on our fertility and threatening human survival. Smart cities intend to optimize the quality of life of their citizens by utilizing technology for smarter living. This research first identifies the requirements and business opportunities of using advanced technology for smarter fertility preservation and assisted reproduction in smart cities. A federated blockchain approach is proposed for the alliance of integrated commercial egg banks (ICEBs). In particular, we designed a membership fee rebate (MFR) mechanism that offers incentives for blockchain creations in the egg banking alliance. We formulated the MFR problem into a leader–followers Stackelberg game whose objectives are (1) to maximize the benefits of forming the alliance (the leader) and (2) to maximize the benefits in each ICEB (the follower). We developed an iterative scheme that utilizes mathematical programming techniques to solve the two-level, Stackelberg game problem. With a given set of parameters of the alliance and membership fee function, and the average number of blocks generated for an oocyte, the iterative scheme achieves the optimal solution for the MFR rate per block created. A numerical example demonstrates the feasibility and applicability of the proposed iterative scheme. Numerical results show that it achieves good solutions in adding a small to medium-sized new ICEB to the existing alliance. The proposed federated approach lays the foundation for developing a blockchain-based egg banking platform.

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.

Accounting for the genetic load in assisted reproductive technology

The genetic load in the human genome has important ramifications for assisted reproductive technology (ART), human reproduction and fertility more generally. Here, we discuss these topics in the light of evolutionary genetic theory, the technological revolution in ART and the advances in the fields of genomics and bioinformatics.

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.

A new insight into a thermoplastic microfluidic device aimed at improvement of oxygenation process and avoidance of shear stress during cell culture

Keeping the oxygen concentration at the desired physiological limits is a challenging task in cellular microfluidic devices. A good knowledge of affecting parameters would be helpful to control the oxygen delivery to cells. This study aims to provide a fundamental understanding of oxygenation process within a hydrogel-based microfluidic device considering simultaneous mass transfer, medium flow, and cellular consumption. For this purpose, the role of geometrical and hydrodynamic properties was numerically investigated. The results are in good agreement with both numerical and experimental data in the literature. The obtained results reveal that increasing the microchannel height delays the oxygen depletion in the absence of media flow. We also observed that increasing the medium flow rate increases the oxygen concentration in the device; however, it leads to high maximum shear stress. A novel pulsatile medium flow injection pattern is introduced to reduce detrimental effect of the applied shear stress on the cells.

Antibody-Conjugated Magnetic Beads for Sperm Sexing Using a Multi-Wall Carbon Nanotube Microfluidic Device

This study proposes a microfluidic device used for X-/Y-sperm separation based on monoclonal antibody-conjugated magnetic beads, which become positively charged in the flow system. Y-sperms were selectively captured via a monoclonal antibody and transferred onto the microfluidic device and were discarded, so that X-sperms can be isolated and commercially exploited for fertilization demands of female cattle in dairy industry. Therefore, the research team used monoclonal antibody-conjugated magnetic beads to increase the force that causes the Y-sperm to be pulled out of the system, leaving only the X-sperm for further use. The experimental design was divided into the following: Model 1, the microfluid system for sorting positive magnetic beads, which yielded 100% separation; Model 2, the sorting of monoclonal antibody-conjugated magnetic beads in the fluid system, yielding 98.84% microcirculation; Model 3, the sorting of monoclonal antibody-conjugated magnetic beads with sperm in the microfluid system, yielding 80.12% microcirculation. Moreover, the fabrication microfluidic system had thin film electrodes created via UV lithography and MWCNTs electrode structure capable of erecting an electrode wall 1500 µm above the floor with a flow channel width of only 100 µm. The system was tested using a constant flow rate of 2 µL/min and X-/Y-sperm were separated using carbon nanotube electrodes at 2.5 V. The structure created with the use of vertical electrodes and monoclonal antibody-conjugated magnetic beads technique produced a higher effective rejection effect and was able to remove a large number of unwanted sperm from the system with 80.12% efficiency.

The influence of the female reproductive tract and sperm features on the design of microfluidic sperm-sorting devices

Although medical advancements have successfully helped a lot of couples with their infertility by assisted reproductive technologies (ART), sperm selection, a crucial stage in ART, has remained challenging. Therefore, we aimed to investigate novel sperm separation methods, specifically microfluidic systems, as they do sperm selection based on sperm and/or the female reproductive tract (FRT) features without inflicting any damage to the selected sperm during the process. In this review, after an exhaustive studying of FRT features, which can implement by microfluidics devices, the focus was centered on sperm selection and investigation devices. During this study, we tried not to only point to the deficiencies of these systems, but to put forth suggestions for their improvement as well.

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.

Use of some cost-effective technologies for a routine clinical pathology laboratory

Classically, the need for highly sophisticated instruments with important economic costs has been a major limiting factor for clinical pathology laboratories, especially in developing countries. With the aim of making clinical pathology more accessible, a wide variety of free or economical technologies have been developed worldwide in the last few years. 3D printing and Arduino approaches can provide up to 94% economical savings in hardware and instrumentation in comparison to commercial alternatives. The vast selection of point-of-care-tests (POCT) currently available also limits the need for specific instruments or personnel, as they can be used almost anywhere and by anyone. Lastly, there are dozens of free and libre digital tools available in health informatics. This review provides an overview of the state-of-the-art on cost-effective alternatives with applications in routine clinical pathology laboratories. In this context, a variety of technologies including 3D printing and Arduino, lateral flow assays, plasmonic biosensors, and microfluidics, as well as laboratory information systems, are discussed. This review aims to serve as an introduction to different technologies that can make clinical pathology more accessible and, therefore, contribute to achieve universal health coverage.

Sperm Selection and Embryo Development: A Comparison of the Density Gradient Centrifugation and Microfluidic Chip Sperm Preparation Methods in Patients with Astheno-Teratozoospermia

In recent years, microfluidic chip-based sperm sorting has emerged as an alternative tool to centrifugation-based conventional techniques for in vitro fertilization. This prospective study aims to compare the effects of density gradient centrifugation and microfluidic chip sperm preparation methods on embryo development in patient populations with astheno-teratozoospermia. In the study, the semen samples of the patients were divided into two groups for preparation with either the microfluidic or density gradient methods. Selected spermatozoa were then used to fertilize mature sibling oocytes and the semen parameters and embryo development on days 3 and 5 were assessed. While the density gradient group was associated with a higher sperm concentration, motility (progressive and total) was significantly higher in the microfluidic chip group. No significant differences were observed in the fertilization rates or grade 1 (G1) and grade 2 (G2) proportions of the third-day embryos. Furthermore, while the proportions of the poor, fair and good blastocysts on day 5 did not differ significantly, excellent blastocysts (indicating high-quality embryos) were observed in a significantly higher proportion of the microfluidic chip group. When compared to the classical density gradient method, the microfluidic chip sperm preparation yielded sperm with higher motility and higher quality blastocysts at day 5; in patients with astheno-teratozoospermia.

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.

A Review on Microfluidics: An Aid to Assisted Reproductive Technology

Infertility is a state of the male or female reproductive system that is defined as the failure to achieve pregnancy even after 12 or more months of regular unprotected sexual intercourse. Assisted reproductive technology (ART) plays a crucial role in addressing infertility. Various ART are now available for infertile couples. Fertilization in vitro (IVF), intracytoplasmic sperm injection (ICSI) and intrauterine insemination (IUI) are the most common techniques in this regard. Various microfluidic technologies can incorporate various ART procedures such as embryo and gamete (sperm and oocyte) analysis, sorting, manipulation, culture and monitoring. Hence, this review intends to summarize the current knowledge about the application of this approach towards cell biology to enhance ART.

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.

Organ-on-a-chip technology for the study of the female reproductive system

Over the past decade, organs-on-a-chip and microphysiological systems have emerged as a disruptive in vitro technology for biopharmaceutical applications. By enabling new capabilities to engineer physiological living tissues and organ units in the precisely controlled environment of microfabricated devices, these systems offer great promise to advance the frontiers of basic and translational research in biomedical sciences. Here, we review an emerging body of interdisciplinary work directed towards harnessing the power of organ-on-a-chip technology for reproductive biology and medicine. The focus of this topical review is to provide an overview of recent progress in the development of microengineered female reproductive organ models with relevance to drug delivery and discovery. We introduce the engineering design of these advanced in vitro systems and examine their applications in the study of pregnancy, infertility, and reproductive diseases. We also present two case studies that use organ-on-a-chip design principles to model placental drug transport and hormonally regulated crosstalk between multiple female reproductive organs. Finally, we discuss challenges and opportunities for the advancement of reproductive organ-on-a-chip technology.

A Comprehensive Review on Intracellular Delivery

Intracellular delivery is considered an indispensable process for various studies, ranging from medical applications (cell-based therapy) to fundamental (genome-editing) and industrial (biomanufacture) approaches. Conventional macroscale delivery systems critically suffer from such issues as low cell viability, cytotoxicity, and inconsistent material delivery, which have opened up an interest in the development of more efficient intracellular delivery systems. In line with the advances in microfluidics and nanotechnology, intracellular delivery based on micro- and nanoengineered platforms has progressed rapidly and held great promises owing to their unique features. These approaches have been advanced to introduce a smorgasbord of diverse cargoes into various cell types with the maximum efficiency and the highest precision. This review differentiates macro-, micro-, and nanoengineered approaches for intracellular delivery. The macroengineered delivery platforms are first summarized and then each method is categorized based on whether it employs a carrier- or membrane-disruption-mediated mechanism to load cargoes inside the cells. Second, particular emphasis is placed on the micro- and nanoengineered advances in the delivery of biomolecules inside the cells. Furthermore, the applications and challenges of the established and emerging delivery approaches are summarized. The topic is concluded by evaluating the future perspective of intracellular delivery toward the micro- and nanoengineered approaches.

Microfluidics in male reproduction: is ex vivo culture of primate testis tissue a future strategy for ART or toxicology research?

The significant rise in male infertility disorders over the years has led to extensive research efforts to recapitulate the process of male gametogenesis in vitro and to identify essential mechanisms involved in spermatogenesis, notably for clinical applications. A promising technology to bridge this research gap is organ-on-chip (OoC) technology, which has gradually transformed the research landscape in ART and offers new opportunities to develop advanced in vitro culture systems. With exquisite control on a cell or tissue microenvironment, customized organ-specific structures can be fabricated in in vitro OoC platforms, which can also simulate the effect of in vivo vascularization. Dynamic cultures using microfluidic devices enable us to create stimulatory effect and non-stimulatory culture conditions. Noteworthy is that recent studies demonstrated the potential of continuous perfusion in OoC systems using ex vivo mouse testis tissues. Here we review the existing literature and potential applications of such OoC systems for male reproduction in combination with novel bio-engineering and analytical tools. We first introduce OoC technology and highlight the opportunities offered in reproductive biology in general. In the subsequent section, we discuss the complex structural and functional organization of the testis and the role of the vasculature-associated testicular niche and fluid dynamics in modulating testis function. Next, we review significant technological breakthroughs in achieving in vitro spermatogenesis in various species and discuss the evidence from microfluidics-based testes culture studies in mouse. Lastly, we discuss a roadmap for the potential applications of the proposed testis-on-chip culture system in the field of primate male infertility, ART and reproductive toxicology.

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.

Multiphase flow in microfluidics: From droplets and bubbles to the encapsulated structures

Microfluidic technologies have a unique ability to control more precisely and effectively on two-phase flow systems in comparison with macro systems. Controlling the size of the droplets and bubbles has led to an ever-increasing expansion of this technology in two-phase systems. Liquid-liquid and gas-liquid two-phase flows because of their numerous applications in different branches such as reactions, synthesis, emulsions, cosmetic, food, drug delivery, etc. have been the most critical two-phase flows in microfluidic systems. This review highlights recent progress in two-phase flows in microfluidic devices. The fundamentals of two-phase flows, including some essential dimensionless numbers, governing equations, and some most well-known numerical methods are firstly introduced, followed by a review of standard methods for producing segmented flows such as emulsions in microfluidic systems. Then various encapsulated structures, a common two-phase flow structure in microfluidic devices, and different methods of their production are reviewed. Finally, applications of two-phase microfluidic flows in drug-delivery, biotechnology, mixing, and microreactors are briefly discussed.

Nanozyme-based electrochemical biosensors for disease biomarker detection

In recent years, a new group of nanomaterials named nanozymes that exhibit enzyme-mimicking catalytic activity has emerged as a promising alternative to natural enzymes. Nanozymes can address some of the intrinsic limitations of natural enzymes such as high cost, low stability, difficulty in storage, and specific working conditions (i.e., narrow substrate, temperature and pH ranges). Thus, synthesis and applications of hybrid and stimuli-responsive advanced nanozymes could revolutionize the current practice in life sciences and biosensor applications. On the other hand, electrochemical biosensors have long been used as an efficient way for quantitative detection of analytes (biomarkers) of interest. As such, the use of nanozymes in electrochemical biosensors is particularly important to achieve low cost and stable biosensors for prognostics, diagnostics, and therapeutic monitoring of diseases. Herein, we summarize the recent advances in the synthesis and classification of common nanozymes and their application in electrochemical biosensor development. After briefly overviewing the applications of nanozymes in non-electrochemical-based biomolecular sensing systems, we thoroughly discuss the state-of-the-art advances in nanozyme-based electrochemical biosensors, including genosensors, immunosensors, cytosensors and aptasensors. The applications of nanozymes in microfluidic-based assays are also discussed separately. We also highlight the challenges of nanozyme-based electrochemical biosensors and provide some possible strategies to address these limitations. Finally, future perspectives on the development of nanozyme-based electrochemical biosensors for disease biomarker detection are presented. We envisage that standardization of nanozymes and their fabrication process may bring a paradigm shift in biomolecular sensing by fabricating highly specific, multi-enzyme mimicking nanozymes for highly sensitive, selective, and low-biofouling electrochemical biosensors.

Methodological considerations for examining the relationship between sperm morphology and motility

Sperm cells of all taxa share a common goal to reach and fertilize an ovum, yet sperm are one of the most diverse cell types in nature. While the structural diversity of these cells is well recognized, the functional significance of variation in sperm design remains elusive. An important function of spermatozoa is a need to migrate toward the ova, often over long distances in a foreign environment, which may include a complex and hostile female reproductive tract. Several comparative and experimental studies have attempted to address the link between sperm morphology and motility, yet the conclusions drawn from these studies are often inconsistent, even within the same taxa. Much of what we know about the functional significance of sperm design in internally fertilizing species has been gleaned from in vitro studies, for which experimental parameters often vary among studies. We propose that discordant results from these studies are in part due to a lack of consistency of methods, conditions that do not replicate those of the female reproductive tract, and the overuse of simple linear measures of sperm shape. Within this review, we provide a toolkit for imaging, quantifying, and analyzing sperm morphology and movement patterns for in vitro studies and discuss emerging approaches. Results from studies linking morphology to motility enhance our understanding of the evolution of adaptive sperm traits and the mechanisms that regulate fertility, thus offering new insights into methods used in assisted reproductive technologies in animal science, conservation and public health.

Engineered reproductive tissues

Engineered male and female biomimetic reproductive tissues are being developed as autonomous in vitro units or as integrated multi-organ in vitro systems to support germ cell and embryo function, and to display characteristic endocrine phenotypic patterns, such as the 28-day human ovulatory cycle. In this Review, we summarize how engineered reproductive tissues facilitate research in reproductive biology, and overview strategies for making engineered reproductive tissues that might eventually allow the restoration of reproductive capacity in patients.

Biohybrid robotics with living cell actuation

This review comprehensively discusses recent advances in the basic components, controlling methods and especially in the applications of biohybrid robots.

Advanced Biotechnology for Cell Cryopreservation

Cell cryopreservation has evolved as an important technology required for supporting various cell-based applications, such as stem cell therapy, tissue engineering, and assisted reproduction. Recent times have witnessed an increase in the clinical demand of these applications, requiring urgent improvements in cell cryopreservation. However, cryopreservation technology suffers from the issues of low cryopreservation efficiency and cryoprotectant (CPA) toxicity. Application of advanced biotechnology tools can significantly improve post-thaw cell survival and reduce or even eliminate the use of organic solvent CPAs, thus promoting the development of cryopreservation. Herein, based on the different cryopreservation mechanisms available, we provide an overview of the applications and achievements of various biotechnology tools used in cell cryopreservation, including trehalose delivery, hydrogel-based cell encapsulation technique, droplet-based cell printing, and nanowarming, and also discuss the associated challenges and perspectives for future development.

Three-Dimensional Modeling of Avascular Tumor Growth in Both Static and Dynamic Culture Platforms

Microfluidic cell culture platforms are ideal candidates for modeling the native tumor microenvironment because they can precisely reconstruct in vivo cellular behavior. Moreover, mathematical modeling of tumor growth can pave the way toward description and prediction of growth pattern as well as improving cancer treatment. In this study, a modified mathematical model based on concentration distribution is applied to tumor growth in both conventional static culture and dynamic microfluidic cell culture systems. Apoptosis and necrosis mechanisms are considered as the main inhibitory factors in the model, while tumor growth rate and nutrient consumption rate are modified in both quiescent and proliferative zones. We show that such modification can better predict the experimental results of tumor growth reported in the literature. Using numerical simulations, the effects of the concentrations of the nutrients as well as the initial tumor radius on the tumor growth are investigated and discussed. Furthermore, tumor growth is simulated by taking into account the dynamic perfusion into the proposed model. Subsequently, tumor growth kinetics in a three-dimensional (3D) microfluidic device containing a U-shaped barrier is numerically studied. For this case, the effect of the flow rate of culture medium on tumor growth is investigated as well. Finally, to evaluate the impact of the trap geometry on the tumor growth, a comparison is made between the tumor growth kinetics in two frequently used traps in microfluidic cell culture systems, i.e., the U-shaped barrier and microwell structures. The proposed model can provide insight into better predicting the growth and development of avascular tumor in both static and dynamic cell culture platforms.

Review on Sperm Sorting Technologies and Sperm Properties toward New Separation Methods via the Interface of Biochemistry and Material Science

Successful fertilization in mammals requires spermatozoa to efficiently traverse the female reproductive tract to meet the egg. This process naturally selects high quality sperm cells for fertilization, but when artificial reproductive technologies are used such as in vitro fertilization, intracytoplasmic sperm injection, or intrauterine insemination, other methods of sperm selection are required. Currently, technology enables sperm sorting based on motility, maturity as defined by zeta potential or hyaluronic acid binding site expression, absence of apoptotic factors, appropriate morphology, and even sex. This review summarizes current knowledge on all known methods of sperm cell sorting, compares their efficiency, and discusses the advantages and limitations of each technique. Scope for further refinement and improvement of current methods are discussed as is the potential to utilize a variety of materials to innovate new methods of sperm separation.

A Multiwell Microfluidic Device for Analyzing and Screening Nonhormonal Contraceptive Agents

Birth control and family planning play pivotal roles in the economic growth and reduction of maternal, infant, and child mortality. Current contraceptives, such as hormonal agents and intrauterine devices, target only a small subset of reproductive processes and can have serious side effects on the health of women. To develop novel contraceptive agents, a scalable microfluidic device is established for analyzing and screening the effects of potential contraceptive agents on the maturation of the cumulus-oocyte complex. The microfluidic device performs on-chip incubation for studying oocyte maturation and cumulus expansion and isolates the microwells by oil-water interfaces to avoid crosstalk between the wells. A filter membrane is incorporated in the device to simplify incubation, medium exchange, washing, and fluorescence staining of oocytes. Cumulus expansion can be monitored directly in the device and oocyte maturation can be examined after enzymatic removal of cumulus cells and on-chip fluorescence staining. The performance of the device is evaluated by studying the influence of three drugs known to block oocyte maturation and/or cumulus expansion.

IVF-on-a-Chip: Recent Advances in Microfluidics Technology for In Vitro Fertilization

In vitro fertilization (IVF) has been one of the most exciting modern medical technologies. It has transformed the landscape of human infertility treatment. However, current IVF procedures still provide limited accessibility and affordability to most infertile couples because of the multiple cumbersome processes and heavy dependence on technically skilled personnel. Microfluidics technology offers unique opportunities to automate IVF procedures, reduce stress imposed upon gametes and embryos, and minimize the operator-to-operator variability. This article describes the rapidly evolving state of the application of microfluidics technology in the field of IVF, summarizes the diverse angles of how microfluidics has been complementing or transforming current IVF protocols, and discusses the challenges that motivate continued innovation in this field.

A Bubble-Free Microfluidic Device for Easy-to-Operate Immobilization, Culturing and Monitoring of Zebrafish Embryos

The development of miniaturized devices for studying zebrafish embryos has been limited due to complicated fabrication and operation processes. Here, we reported on a microfluidic device that enabled the capture and culture of zebrafish embryos and real-time monitoring of dynamic embryonic development. The device was simply fabricated by bonding two layers of polydimethylsiloxane (PDMS) structures replicated from three-dimensional (3D) printed reusable molds onto a flat glass substrate. Embryos were easily loaded into the device with a pipette, docked in traps by gravity, and then retained in traps with hydrodynamic forces for long-term culturing. A degassing chamber bonded on top was used to remove air bubbles from the embryo-culturing channel and traps so that any embryo movement caused by air bubbles was eliminated during live imaging. Computational fluid dynamics simulations suggested this embryo-trapping and -retention regime to exert low shear stress on the immobilized embryos. Monitoring of the zebrafish embryogenesis over 20 h during the early stages successfully verified the performance of the microfluidic device for culturing the immobilized zebrafish embryos. Therefore, this rapid-prototyping, low-cost and easy-to-operate microfluidic device offers a promising platform for the long-term culturing of immobilized zebrafish embryos under continuous medium perfusion and the high-quality screening of the developmental dynamics.

Cryoprotectant-Free Freezing of Cells Using Liquid Marbles Filled with Hydrogel

Cryopreservation without cryoprotectant remains a significant challenge for the re-establishment of cell culture after freeze-thaw. Thus, finding an alternative and a simple cryopreservation method is necessary. Liquid marble (LM)-based digital microfluidics is a promising approach for cryoprotectant-free cryopreservation. However, the use of this platform to efficiently preserve samples with low cell density and well-controlled serum concentrations has not been investigated. We addressed this issue by embedding an agarose-containing fetal bovine serum (FBS) inside the LM. A low density of 500 cells/μL of murine 3T3 cells was selected for evaluating the postcryogenic survivability. The effects on the post-thaw cell viability of the concentration of agarose, the amount of FBS inside the agarose, and the volume of the LM were investigated systematically. This paper also presents an analysis on the changes in shape and crack size of post-thawed agarose. The results revealed that the embedded agarose gel serves as a controlled release mechanism of FBS and significantly improves cell viability. Post-thaw recovery sustains major cellular features, such as viability, cell adhesion, and morphology. The platform technology reported here opens up new possibilities to cryopreserve rare biological samples without the toxicity risk of cryoprotectants.

On-chip oocyte denudation from cumulus-oocyte complexes for assisted reproductive therapy

Human infertility can be treated using assisted reproductive technology (ART) such as intracytoplasmic sperm injection (ICSI). But current ART techniques suffer from multiple cumbersome processes requiring technically skilled personnel. Microfluidics technologies offer unique opportunities to streamline ART procedures, reduce stress imposed upon gametes and embryos, and minimize the operator-to-operator variability. However, there have been no automated and continuous processing systems that can reduce the dependence on well-trained embryologists to obtain ICSI-ready oocytes from patients. In this study, using mouse models, we developed a microfluidic device to denude oocytes from the surrounding cumulus-corona cell mass, facilitating the evaluation of oocyte quality and the injection of sperm. Enzyme-treated cumulus-oocyte complexes pass through a series of jagged-surface constriction microchannels of optimized geometries. The jagged inner wall of constriction channels facilitates stripping off of the cumulus-corona cell mass. Oocytes that were denuded by the device showed comparable fertilization and developmental competence compared with mechanical pipetting. The device developed in this study achieves the automation of a manual process for oocyte denudation in a continuous flow, as well as improving standardization and ease-of-use. Our denudation-on-a-chip approach requires inexpensive and simple equipment, which represents one step forward towards improving the accessibility and affordability of assisted reproductive therapy.

A high-performance polydimethylsiloxane electrospun membrane for cell culture in lab-on-a-chip

Thin porous membranes are important components in a microfluidic device, serving as separators, filters, and scaffolds for cell culture. However, the fabrication and the integration of these membranes possess many challenges, which restrict their widespread applications. This paper reports a facile technique to fabricate robust membrane-embedded microfluidic devices. We integrated an electrospun membrane into a polydimethylsiloxane (PDMS) device using the simple plasma-activated bonding technique. To increase the flexibility of the membrane and to address the leakage problem, the electrospun membrane was fabricated with the highest weight ratio of PDMS to polymethylmethacrylate (i.e., 6:1 w/w). The membrane-integrated microfluidic device could withstand a flow rate of up to 50 μl/min. As a proof of concept, we demonstrated that such a compartmentalized microfluidic platform could be successfully used for cell culture with the capability of providing a more realistic in vivo-like condition. Human lung cancer epithelial cells (A549) were seeded on the membrane from the top microchannel, while the continuous flow of the culture medium through the bottom microchannel provided a shear-free cell culture condition. The tortuous micro-/nanofibers of the membrane immobilized the cells within the hydrophobic micropores and with no need of extracellular matrix for cell adhesion and cell growth. The hydrophobic surface conditions of the membrane were suitable for anchorage-independent cell types. To further extend the application of the device, we qualitatively showed that rinsing the membrane with ethanol prior to cell seeding could temporarily render the membrane hydrophilic and the platform could also be used for anchorage-dependent cells. Due to the three-dimensional (3D) topography of the membranes, three different configurations were observed, including individual single cells, monolayer cells, and 3D cell clusters. This cost-effective and robust compartmentalized microfluidic device may open up new avenues in translational medicine and pharmacodynamics research.

Prediction of Necrotic Core and Hypoxic Zone of Multicellular Spheroids in a Microbioreactor with a U-Shaped Barrier

Microfluidic devices have been widely used for biological and cellular studies. Microbioreactors for three-dimensional (3D) multicellular spheroid culture are now considered as the next generation in in vitro diagnostic tools. The feasibility of using 3D cell aggregates to form multicellular spheroids in a microbioreactor with U-shaped barriers has been demonstrated experimentally. A barrier array is an alternative to commonly used microwell traps. The present study investigates oxygen and glucose concentration distributions as key parameters in a U-shaped array microbioreactor using finite element simulation. The effect of spheroid diameter, inlet concentration and flow rate of the medium are systematically studied. In all cases, the channel walls are considered to be permeable to oxygen. Necrotic and hypoxic or quiescent regions corresponding to both oxygen and glucose concentration distributions are identified for various conditions. The results show that the entire quiescent and necrotic regions become larger with increasing spheroid diameter and decreasing inlet and wall concentration. The shear stress (0.5⁻9 mPa) imposed on the spheroid surface by the fluid flow was compared with the critical values to predict possible damage to the cells. Finally, optimum range of medium inlet concentration (0.13⁻0.2 mM for oxygen and 3⁻11 mM for glucose) and flow rate (5⁻20 μL/min) are found to form the largest possible multicellular spheroid (500 μm), without any quiescent and necrotic regions with an acceptable shear stress. The effect of cell-trap types on the oxygen and glucose concentration inside the spheroid was also investigated. The levels of oxygen and glucose concentration for the microwell are much lower than those for the other two traps. The U-shaped barrier created with microposts allows for a continuous flow of culture medium, and so improves the glucose concentration compared to that in the integrated U-shaped barrier. Oxygen concentration for both types of U-shaped barriers is nearly the same. Due to the advantage of using U-shaped barriers to culture multicellular spheroids, the results of this paper can help to choose the experimental and design parameters of the microbioreactor.