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Thompson JG, McLennan HJ, Heinrich SL, Inge MP, Gardner DK, Harvey AJ. A brief history of technical developments in intracytoplasmic sperm injection (ICSI). Dedicated to the memory of J.M. Cummins. Reprod Fertil Dev 2024; 36:RD24047. [PMID: 38902908 DOI: 10.1071/rd24047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/29/2024] [Indexed: 06/22/2024] Open
Abstract
Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technology for treatment of severe male infertility introduced into clinical practice in 1992. This review provides a brief history of the development of ICSI by acknowledging major developments in the field. The review addresses key developments in pre-clinical and early studies, how ICSI compares with in vitro fertilisation, long-term consequences, how the mechanistic approach to ICSI has changed in both manual and semi-automated approaches, and how sperm selection procedures are integrated into ICSI. From the beginnings using animal models in the 1960-1970s, the development of ICSI is a remarkable and transformative success story. Indeed, its broad use (70% of cycles globally) exceeds the need required for treating infertile males, and this remains a controversial issue. There remain questions around the long-term health impacts of ICSI. Furthermore, advances in automation of the ICSI procedure are occurring. An estimated 6million children have been born from the ICSI procedure. With further automation of sperm selection technologies, coupled with automation of the injection procedure, it is likely that the proportion of children born from ICSI will further increase.
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Affiliation(s)
- J G Thompson
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA 5005, Australia; and Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia; and ART Lab Solutions Pty Ltd, 10 Pulteney Street, Adelaide, SA 5005, Australia
| | - H J McLennan
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA 5005, Australia
| | - S L Heinrich
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA 5005, Australia
| | - M P Inge
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA 5005, Australia
| | - D K Gardner
- Melbourne IVF, East Melbourne, Vic 3002, Australia; and School of BioSciences, University of Melbourne, Parkville, Vic 3010, Australia
| | - A J Harvey
- Melbourne IVF, East Melbourne, Vic 3002, Australia; and School of BioSciences, University of Melbourne, Parkville, Vic 3010, Australia
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McLennan HJ, Heinrich SL, Inge MP, Wallace SJ, Blanch AJ, Hails L, O'Connor JP, Waite MB, McIlfatrick S, Nottle MB, Dunning KR, Gardner DK, Thompson JG, Love AK. A micro-fabricated device (microICSI) improves porcine blastocyst development and procedural efficiency for both porcine intracytoplasmic sperm injection and human microinjection. J Assist Reprod Genet 2024; 41:297-309. [PMID: 38236552 PMCID: PMC10894805 DOI: 10.1007/s10815-023-03018-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/21/2023] [Indexed: 01/19/2024] Open
Abstract
PURPOSE Intracytoplasmic sperm injection (ICSI) imparts physical stress on the oolemma of the oocyte and remains among the most technically demanding skills to master, with success rates related to experience and expertise. ICSI is also time-consuming and requires workflow management in the laboratory. This study presents a device designed to reduce the pressure on the oocyte during injection and investigates if this improves embryo development in a porcine model. The impact of this device on laboratory workflow was also assessed. METHODS Porcine oocytes were matured in vitro and injected with porcine sperm by conventional ICSI (C-ICSI) or with microICSI, an ICSI dish that supports up to 20 oocytes housed individually in microwells created through microfabrication. Data collected included set-up time, time to align the polar body, time to perform the injection, the number of hand adjustments between controllers, and degree of invagination at injection. Developmental parameters measured included cleavage and day 6 blastocyst rates. Blastocysts were differentially stained to assess cell numbers of the inner cell mass and trophectoderm. A pilot study with human donated MII oocytes injected with beads was also performed. RESULTS A significant increase in porcine blastocyst rate for microICSI compared to C-ICSI was observed, while cleavage rates and blastocyst cell numbers were comparable between treatments. Procedural efficiency of microinjection was significantly improved with microICSI compared to C-ICSI in both species. CONCLUSION The microICSI device demonstrated significant developmental and procedural benefits for porcine ICSI. A pilot study suggests human ICSI should benefit equally.
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Affiliation(s)
- Hanna J McLennan
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Shauna L Heinrich
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Megan P Inge
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Samuel J Wallace
- Virtual Ark Pty Ltd, 73 Woolnough Road, Semaphore, SA, 5019, Australia
| | - Adam J Blanch
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Llewelyn Hails
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - John P O'Connor
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Michael B Waite
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Stephen McIlfatrick
- School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Mark B Nottle
- School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Kylie R Dunning
- School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, The University of Adelaide, Adelaide, SA, 5005, Australia
- Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - David K Gardner
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
- Melbourne IVF, East Melbourne, VIC, 3002, Australia
- School of BioSciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Jeremy G Thompson
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia.
- Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, SA, 5005, Australia.
- ART Lab Solutions Pty Ltd, 10 Pulteney Street, Adelaide, SA, 5005, Australia.
| | - Allison K Love
- Fertilis Pty Ltd, Frome Road, Helen Mayo South, The University of Adelaide, Adelaide, SA, 5005, Australia
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Gardner DK, Sakkas D. Making and selecting the best embryo in the laboratory. Fertil Steril 2023; 120:457-466. [PMID: 36521518 DOI: 10.1016/j.fertnstert.2022.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/20/2022] [Accepted: 11/07/2022] [Indexed: 12/15/2022]
Abstract
Over the past 4 decades our ability to maintain a viable human embryo in vitro has improved dramatically, leading to higher implantation rates. This has led to a notable shift to single blastocyst transfer and the ensuing elimination of high order multiple gestations. Future improvements to embryo culture systems will not only come from new improved innovative media formulations (such as the inclusion of antioxidants), but plausibly by moving away from static culture to more dynamic perfusion-based systems now made a reality owing to the breakthroughs in three-dimensional printing technology and micro fabrication. Such an approach has already made it feasible to create high resolution devices for intracytoplasmic sperm injection, culture, and cryopreservation, paving the way not only for improvements in outcomes but also automation of assisted reproductive technology. Although improvements in culture systems can lead to further increases in pregnancy outcomes, the ability to quantitate biomarkers of embryo health and viability will reduce time to pregnancy and decrease pregnancy loss. Currently artificial intelligence is being used to assess embryo development through image analysis, but we predict its power will be realized through the creation of selection algorithms based on the integration of information related to metabolic functions, cell-free DNA, and morphokinetics, thereby using vast amounts of different data types obtained for each embryo to predict outcomes. All of this will not only make assisted reproductive technology more effective, but it will also make it more cost effective, thereby increasing patient access to infertility treatment worldwide.
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Affiliation(s)
- David K Gardner
- Melbourne IVF, East Melbourne, Victoria, Australia; School of BioSciences, University of Melbourne, Melbourne, Victoria, Australia.
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Costa-Borges N, Munné S, Albó E, Mas S, Castelló C, Giralt G, Lu Z, Chau C, Acacio M, Mestres E, Matia Q, Marquès L, Rius M, Márquez C, Vanrell I, Pujol A, Mataró D, Seth-Smith M, Mollinedo L, Calderón G, Zhang J. First babies conceived with Automated Intracytoplasmic Sperm Injection. Reprod Biomed Online 2023; 47:103237. [PMID: 37400320 DOI: 10.1016/j.rbmo.2023.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 07/05/2023]
Abstract
RESEARCH QUESTION Can an automated sperm injection robot perform Automated Intracytoplasmic Sperm Injection (ICSIA) for use in human IVF? DESIGN The ICSIA robot automated the sperm injection procedure, including injection pipette advancement, zona pellucida and oolemma penetration with piezo pulses, and pipette removal after sperm release. The robot was first tested in mouse, hamster and rabbit oocytes, and subsequently using discarded human oocytes injected with microbeads. A small clinical pilot trial was conducted with donor oocytes to study the feasibility of the robot in a clinical setting. The ICSIA robot was controlled by engineers with no micromanipulation experience. Results were compared with those obtained with manual ICSI conducted by experienced embryologists. RESULTS The ICSIA robot demonstrated similar results to the manual procedure in the different animal models tested as well as in the pre-clinical validations conducted in discarded human oocytes. In the clinical validation, 13 out of 14 oocytes injected with ICSIA fertilized correctly versus 16 out of 18 in the manual control; eight developed into good-quality blastocysts versus 12 in the manual control; and four were diagnosed as chromosomally normal versus 10 euploid in the manual control. Three euploid blastocysts from the ICSIA robot group have been transferred into two recipients, which resulted in two singleton pregnancies and two babies born. CONCLUSIONS The ICSIA robot showed high proficiency in injecting animal and human oocytes when operated by inexperienced personnel. The preliminary results obtained in this first clinical pilot trial are within key performance indicators.
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Affiliation(s)
| | | | | | | | | | | | - Zhuo Lu
- New Hope Fertility Center, NY, USA
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Nano-liter perfusion microfluidic device made entirely by two-photon polymerization for dynamic cell culture with easy cell recovery. Sci Rep 2023; 13:562. [PMID: 36631601 PMCID: PMC9834384 DOI: 10.1038/s41598-023-27660-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023] Open
Abstract
Polydimethylsiloxane (PDMS) has been the material of choice for microfluidic applications in cell biology for many years, with recent advances encompassing nano-scaffolds and surface modifications to enhance cell-surface interactions at nano-scale. However, PDMS has not previously been amenable to applications which require complex geometries in three dimensions for cell culture device fabrication in the absence of additional components. Further, PDMS microfluidic devices have limited capacity for cell retrieval following culture without severely compromising cell health. This study presents a designed and entirely 3D-printed microfluidic chip (8.8 mm × 8.2 mm × 3.6 mm) using two-photon polymerization (2PP). The 'nest' chip is composed of ten channels that deliver sub-microliter volume flowrates (to ~ 600 nL/min per channel) to 10 individual retrievable cell sample 'cradles' that interlock with the nest to create the microfluidic device. Computational fluid dynamics modelling predicted medium flow in the device, which was accurately validated by real-time microbead tracking. Functional capability of the device was assessed, and demonstrated the capability to deliver culture medium, dyes, and biological molecules to support cell growth, staining and cell phenotype changes, respectively. Therefore, 2PP 3D-printing provides the precision needed for nanoliter fluidic devices constructed from multiple interlocking parts for cell culture application.
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Yagoub SH, Lim M, Tan TCY, Chow DJX, Dholakia K, Gibson BC, Thompson JG, Dunning KR. Vitrification within a nanoliter volume: oocyte and embryo cryopreservation within a 3D photopolymerized device. J Assist Reprod Genet 2022; 39:1997-2014. [PMID: 35951146 PMCID: PMC9474789 DOI: 10.1007/s10815-022-02589-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Vitrification permits long-term banking of oocytes and embryos. It is a technically challenging procedure requiring direct handling and movement of cells between potentially cytotoxic cryoprotectant solutions. Variation in adherence to timing, and ability to trace cells during the procedure, affects survival post-warming. We hypothesized that minimizing direct handling will simplify the procedure and improve traceability. To address this, we present a novel photopolymerized device that houses the sample during vitrification. Methods The fabricated device consisted of two components: the Pod and Garage. Single mouse oocytes or embryos were housed in a Pod, with multiple Pods docked into a Garage. The suitability of the device for cryogenic application was assessed by repeated vitrification and warming cycles. Oocytes or early blastocyst-stage embryos were vitrified either using standard practice or within Pods and a Garage and compared to non-vitrified control groups. Post-warming, we assessed survival rate, oocyte developmental potential (fertilization and subsequent development) and metabolism (autofluorescence). Results Vitrification within the device occurred within ~ 3 nL of cryoprotectant: this volume being ~ 1000-fold lower than standard vitrification. Compared to standard practice, vitrification and warming within our device showed no differences in viability, developmental competency, or metabolism for oocytes and embryos. The device housed the sample during processing, which improved traceability and minimized handling. Interestingly, vitrification-warming itself, altered oocyte and embryo metabolism. Conclusion The Pod and Garage system minimized the volume of cryoprotectant at vitrification—by ~ 1000-fold—improved traceability and reduced direct handling of the sample. This is a major step in simplifying the procedure.
Supplementary information The online version contains supplementary material available at 10.1007/s10815-022-02589-8.
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Affiliation(s)
- Suliman H Yagoub
- Australian Research Council (ARC) Centre of Excellence for Nanoscale BioPhotonics (CNBP), Adelaide, South Australia, 5000, Australia.,School of Biomedicine, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, 5005, Australia.,Institute for Photonics and Advanced Sensing (IPAS), University of Adelaide, Adelaide, South Australia, 5000, Australia
| | - Megan Lim
- Australian Research Council (ARC) Centre of Excellence for Nanoscale BioPhotonics (CNBP), Adelaide, South Australia, 5000, Australia.,School of Biomedicine, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, 5005, Australia.,Institute for Photonics and Advanced Sensing (IPAS), University of Adelaide, Adelaide, South Australia, 5000, Australia
| | - Tiffany C Y Tan
- Australian Research Council (ARC) Centre of Excellence for Nanoscale BioPhotonics (CNBP), Adelaide, South Australia, 5000, Australia.,School of Biomedicine, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, 5005, Australia.,Institute for Photonics and Advanced Sensing (IPAS), University of Adelaide, Adelaide, South Australia, 5000, Australia
| | - Darren J X Chow
- Australian Research Council (ARC) Centre of Excellence for Nanoscale BioPhotonics (CNBP), Adelaide, South Australia, 5000, Australia.,School of Biomedicine, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, 5005, Australia.,Institute for Photonics and Advanced Sensing (IPAS), University of Adelaide, Adelaide, South Australia, 5000, Australia
| | - Kishan Dholakia
- School of Physics and Astronomy, University of St Andrews, North Haugh, Scotland, KY16 9SS.,School of Biological Sciences, The University of Adelaide, Adelaide, SA, 5005, Australia.,Department of Physics, College of Science, Yonsei University, Seoul, 03722, South Korea
| | - Brant C Gibson
- Australian Research Council (ARC) Centre of Excellence for Nanoscale BioPhotonics (CNBP), Adelaide, South Australia, 5000, Australia.,School of Science, RMIT, Melbourne, VIC, 3001, Australia
| | - Jeremy G Thompson
- Australian Research Council (ARC) Centre of Excellence for Nanoscale BioPhotonics (CNBP), Adelaide, South Australia, 5000, Australia.,School of Biomedicine, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, 5005, Australia.,Institute for Photonics and Advanced Sensing (IPAS), University of Adelaide, Adelaide, South Australia, 5000, Australia.,Fertilis Pty Ltd, Adelaide, South Australia, 5005, Australia
| | - Kylie R Dunning
- Australian Research Council (ARC) Centre of Excellence for Nanoscale BioPhotonics (CNBP), Adelaide, South Australia, 5000, Australia. .,School of Biomedicine, Robinson Research Institute, University of Adelaide, Adelaide, South Australia, 5005, Australia. .,Institute for Photonics and Advanced Sensing (IPAS), University of Adelaide, Adelaide, South Australia, 5000, Australia.
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The effect of discrete wavelengths of visible light on the developing murine embryo. J Assist Reprod Genet 2022; 39:1825-1837. [PMID: 35737174 PMCID: PMC9428105 DOI: 10.1007/s10815-022-02555-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 06/15/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE A current focus of the IVF field is non-invasive imaging of the embryo to quantify developmental potential. Such approaches use varying wavelengths to gain maximum biological information. The impact of irradiating the developing embryo with discrete wavelengths of light is not fully understood. Here, we assess the impact of a range of wavelengths on the developing embryo. METHODS Murine preimplantation embryos were exposed daily to wavelengths within the blue, green, yellow, and red spectral bands and compared to an unexposed control group. Development to blastocyst, DNA damage, and cell number/allocation to blastocyst cell lineages were assessed. For the longer wavelengths (yellow and red), pregnancy/fetal outcomes and the abundance of intracellular lipid were investigated. RESULTS Significantly fewer embryos developed to the blastocyst stage when exposed to the yellow wavelength. Elevated DNA damage was observed within embryos exposed to blue, green, or red wavelengths. There was no effect on blastocyst cell number/lineage allocation for all wavelengths except red, where there was a significant decrease in total cell number. Pregnancy rate was significantly reduced when embryos were irradiated with the red wavelength. Weight at weaning was significantly higher when embryos were exposed to yellow or red wavelengths. Lipid abundance was significantly elevated following exposure to the yellow wavelength. CONCLUSION Our results demonstrate that the impact of light is wavelength-specific, with longer wavelengths also impacting the embryo. We also show that effects are energy-dependent. This data shows that damage is multifaceted and developmental rate alone may not fully reflect the impact of light exposure.
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