Welcome to the IVF Garage

A new IVF technique that places embryos in an automated platform could revolutionise fertility assistance, and send success rates soaring.

It is a process that has helped millions of people worldwide to conceive, creating a revolution in fertility over the last 40 years.

However, in vitro fertilisation, or IVF, remains an invasive and expensive procedure, and the success rate has been stubbornly low over the decades since its development.

Fewer than 1 in 5 IVF attempts results in the birth of a healthy baby in Australia today. But scientists at the Centre for Nanoscale BioPhotonics (CNBP) are working to improve this.

The team has designed a concept known as the ‘IVF garage’, which aims to automate as many steps of the process as possible, thereby lowering the risk of human error.

‘The main focus is looking at technologies to remove the manual handling, as it induces a very high variability in the success of the IVF treatment,’ says University of Adelaide PhD candidate and CNBP researcher, Suliman Yagoub.

‘The traditional methods of growing embryos in the laboratory by experienced embryologists means there’s a large element of chance — not only will the results differ within each clinic, success rates and selection can vary greatly between clinics.’

Improvements in this field could save countless couples and individuals from financial strain, heartache and time spent engaging in less optimised, and potentially invasive, procedures.

Stage 1: Collecting the egg and sperm

In the first stage of IVF, the egg and sperm are collected and placed in a controlled temperature and pH incubator environment. A specialist embryologist ‘cleans’ the sperm and chooses what appear to be the best candidates for fertilisation.

To continuously monitor this environment, the CNBP team, led by Prof Jeremy Thompson, has developed hyper-sensitive fluid sensors that can measure temperature and pH levels without disturbing the cells in their environment.

The team have also found a way to use hyperspectral imaging to monitor the real-time development of the embryos throughout the process using biological markers to determine the embryo’s metabolic profile.

They have also applied hyperspectral imaging to help determine which are the healthiest candidates, and which have irregularities in their genetic make-up that might cause issues during pregnancy; currently an embryo biopsy is required to assess this.

Stage 2: Insemination and monitoring development

The insemination stage involves combining the egg and sperm in the same medium, and this is where the IVF garage gets its name: the technique sees the egg and sperm housed within an automated pod, and docked into a garage that allows embryologists to apply gradual and steady changes to the components of the fluid, mimicking the development conditions in the reproductive tract.

The embryologist will then check for 2 distinctive nuclei in the cell. If 2 are present, the process has been successful so far. Currently, if they are progressing well, the embryos are transferred to another dish, and returned to the incubator. This additional handling is not required in the automated system, as the fluid’s composition adjusts to the embryo’s need — they can remain docked in their pods, safe from human error or accidental environmental change. Embryos are then tracked automatically to assess their development using time-lapse technology.

Stage 3: Embryo selection

A crucial step in the IVF process is to select the ‘best’ or ‘healthiest’ embryo to transfer back into the patient. This procedure currently involves an embryologist assessing each embryo based on either visual assessment, or assessment of the genetic markers that determine the number of chromosomes in the embryo, by way of a biopsy – that is, removing cells from the embryo for testing.

This process is not only unreliable, according to new research, it is also invasive and could lead to complications down the track.

To assess embryo health, CNBP researchers use an optical system to collect biological information about the cells.

‘What most people don’t realise is that there are molecules inside cells that will fluoresce if you shine the right wavelength of light at the right intensity. You can then measure the quantity of those particular molecules, many of which are involved in cell metabolism’ explains Prof Jeremy Thompson, former chief investigator at CNBP.

‘We call this process auto-fluorescence.’

The light fluorescence, captured by a camera developed for use in space, can alert embryologists to irregularities in the formation of cells that will go on to become the placenta or the fetus, using a series of algorithms.

A similar approach has already yielded impressive pregnancy results in cattle, with trials reaching 90% success rates – an outcome even Prof Thompson was surprised by.

The final stage: Monitoring fetal development

Once the embryo has been implanted back into the patient’s uterus, the final stage is ongoing monitoring of fetus development.

Here, too, CNBP technology will have an impact. ‘The same technology we are developing for monitoring embryo development, we can use for non-invasive fetal monitoring in real time,’ Yagoub says.

Monitoring embryonic development in real time, and non-invasively, will assist clinicians in deciding on the best way to manage a pregnancy and birth.

Yagoub says not only will these new techniques improve IVF outcomes for couples and individuals the world over, they also allow for better access to assisted reproductive technologies, due to the automated and equipment-based nature of the procedure.

‘The legacy is that there will be fair treatment for all patients everywhere around the globe,’ he says.

‘Everyone will have access to this technology, whether in rural or remote areas, and the cost of treatment will be less.’