Human eggs are one of the most precious and expensive biological materials and through CL-ICSI technology can serve IVF fraternity and patients with improved success rates, affordability and experience during the IVF treatment and journey
By Dr Sravan K Payeli, IVF Precisions
Sub-fertility is on the rise globally, one in six couples are affected by some form of fertility concerns. Reasons such as lifestyle, stress, late marriages, food habits and many other reasons contribute to the cause. Infertility or Subfertility is a nonterminal disease. Assisted Reproductive Technologies (ART) offers a treatment option for treating infertility. In vitro Fertilization (IVF) techniques belong to ART methods that offer millions of couples with infertility to fulfill their dream of starting parenthood who otherwise fail to conceive by natural means. IVF procedure consists of oocytes (Eggs) collected from the ovaries of the prospective mother and are inseminated with husband sperms.
These gametes are allowed for fertilisation under controlled environment in the IVF lab that mimics human physiological conditions and facilitate the development of D3 or D5 (blastocyst) embryo stage. Healthy embryos are transferred into the uterus in the same cycle (Fresh transfer) or frozen (Vitrification) for subsequent cycle transfers (Frozen Embryo Transfer) for implantation. Conception is confirmed with an optimal beta hCG (human Chorionic Gonadotropin) hormone positive and followed by nine months full term into live birth.
In India, infertility is growing at an alarming rate among married couples due to several factors, such as age, changes in lifestyle, obesity, pollution, stress and various other reasons. According to the report from the National Health Portal infertility affects up to 15 per cent of reproductive-aged couples worldwide. Among these, India alone contributes to 25 per cent of the cases with 15-20 million infertility couples.
The IVF market in India is valued at $472.8 million and projected to reach $1,453.9 million by 2026 registering at a CAGR (compound annual growth rate) of 14.7 per cent according to a report from Allied Market Research. Despite the growing demand for IVF due to raising infertility among the population, the success rate of IVF remains very low (success rate of 39.6 per cent and 11.5 per cent, for women of age, is under 35 years and above 40 years, respectively). Due to a lack of advancement in IVF procedures aided by innovative devices
and technologies, which is therefore becoming a bottleneck to successfully treating infertility or achieving
improved success rates.
Human egg quality measurement
IVF success rates depend on multiple factors such as egg (50 per cent), sperm (30 per cent) and endometrium (20 per cent). Semen analysis and endometrium quality analysis are already in place and several advancements such as AI and diagnosis of correct implantation window are being implemented in several clinics for the sperm and endometrium fertility factors. Egg quality diagnosis has a lot of room for improvement. Recently, a few AI
players are working on predicting egg quality using AI based on images taken after the denudation of human oocytes from an OPU process for both fertility preservation and IVF outcome prediction.
Last 30 years, after the introduction of the Intracytoplasmic Sperm Injection (ICSI) process for human oocytes by Dr Susane and Dr Palermo, several research groups pondered on introducing a variety of advanced techniques to understand or define oocyte quality based on oocyte biomechanics during ICSI (See Fig 2). It is given that without such technologies embryologists use their experience and intuition to understand the quality of oocytes during ICSI as fragile, optimal and hyperelastic oocytes. A percentage given in their mind is learned and understood as the expected outcome during embryo formation.
Applications of human egg quality diagnosis
For this reason and with our own embryology experience, we came up with an innovative oocyte biomechanical property measurement technology called CL-ICSI (Click-SI). CLICSI device is a sperm injection syringe
that is equipped with mechanical engineering and electronic engineering components developed in collaboration with Qualitech, Bengaluru and AMSys, Germany. With our technology, we would like to introduce an objective measurable oocyte biomechanical property measurement system. We hope this technology addresses the concerns of egg quality diagnosis and identification of functional sperm that is capable of fertilising an egg. In addition, we would like to extend this innovative data using artificial intelligence to predict the number of embryos formed on D5/D6 under given circumstances of sperms injected. Moreover, we believe that human egg quality can become an asset in determining the good quality embryo and its selection process for improving implantation rates, promoting single embryo transfers and minimising missed carriages that are deduced from egg inherent biomechanical properties.
In conclusion, Invitro Fertilisation is a complex clinical process that involves several variables, such as fertility specialists, embryologists, IVF lab QA/ QC, on their other hand inherent egg, sperm and endometrium qualities. Implementation of correct diagnosis, options and time/embryo selection process enabled by innovative technologies helps achieve improved success rates and patient experience for millions of couples. In addition, egg quality diagnosis technologies open a new arena to develop new drugs for improving egg quality in women that may help success rates in both IUI and IVF procedures.
References
1. ht tps: / /www.nhp.gov. in/disease/ reproductive-system/infertility
2. Need and feasibility of providing assisted technologies for infertility management in resource-poor settings; Vol. 30, No. 6-7 June-July, 2000 (ICMR BULLETIN)
3. https://www.alliedmarketresearch.com/india-ivf-services-market
4. https://www.fertilityiq.com/ivf-in-vitrofertilization/ ivf-success-rates#the-impact-ofdonor-
eggs-donor-sperm-or-a-gestationalsurrogate
5. https://www.alliedmarketresearch.com/invitro-fertilization-devices-and-consumablesmarket
6. https://worldwide.espacenet.com/patent/search?q=sravan%20payeli
