P-312 Automated sperm selection software (SiD) is as good as human selection for ICSI

Abstract

Study question: Automated sperm selection or human eye‐based sperm selection, does it make a difference on IVF lab outcomes? Summary answer: Single sperm selection by the AI SiD was as proficient as highly experienced embryologists and embryo development may have improved for inexperienced embryologists. What is known already: The implementation of artificial intelligence in reproductive medicine has proven effective for a variety of applications. One application for this technology is single sperm selection during ICSI. The computer assisted program SiD, was designed to grade sperm, in real‐time, based on motility parameters transforming qualitative sperm assessments into a quantitative score. SiD's assistance can be used to select the most optimal sperm for ICSI. The application of sperm selection by AI is expected to bypass user bias, fatigue, limited training, while also optimising time. However, there are limited studies correlating the usage of AI for sperm selection with ICSI outcomes. Study design, size, duration: Between August and November 2022, sibling MII oocytes were randomly divided in two groups; 1‐ICSIgroup: ICSI performed with sperm selected by the embryologist based on motility and 2‐ SID‐ICSIgroup: ICSI performed with sperm selected using SiD software. Priority was given to sperm classified as “Best” by SID software for ICSI. “good” sperm were considered as second choice. Morphology selection was performed before ICSI in both groups. Embryos were cultured during 6 days in same conditions. Participants/materials, setting, methods: Sperm preparation was performed using a microfluidic chamber (ZymotTM). Sperm selection was performed as previously described, and ICSI was performed following routine procedures. Biological outcomes were analysed in both groups and compared including fertilization rate, cleavage rate, embryo and blastocyst development rate, top quality embryo rate and blastocyst development rate. Biological outcomes in both groups were also compared based on embryologist seniority. Finally, embryo morphokinetics parameters were analysed in both groups through manual TLT annotations. Main results and the role of chance: A total of 226 MII oocytes were included in “ICSI group” and 227 in 'SID‐ICSI group. A non significant trend towards better outcomes was observed in the SID‐ICSI group for all biological outcomes including fertilization rate (81,5% vs 80,5%), cleavage rate (98,4% vs 97,3%), day 3 embryo development rate (77,8% vs 73,1%), top quality development rate at day 3 (50,8% vs 50,0%), blastocyst development rate at day 5 (49,7% vs 45,1%), good quality blastocyst development rate at day 5 (48,1% vs 46,2%), top quality blastocyst development rate at day 5 (25,4% vs 23,1%). Similarly, a non‐significant increase was observed in all these outcomes when comparing both groups when sperm selection is performed by a junior embryologist. Conversely, no difference was seen in both groups when sperm selection is performed by a senior embryologist. Finally, no significant difference was observed in the SID‐ICSI group for all fertilization events (tPB2, cytoplasmic wave, tPN1, tPN2, presence of cytoplasmic halo, tPNf, and disappearance of cytoplasmic halo) other cleavage timings (t2‐>t10, tM, tSC, tEC, tSB) and embryonic cell cycles (ECC1, ECC2, ECC3 s2, s3). Limitations, reasons for caution: The Zymot™ microfluidic chamber was used for sperm preparation. This device optimises sperm selection, giving rise to an already optimised population of spermatozoa. Future investigations evaluating the effect of SiD automated sperm selection software on biological outcomes in samples prepared with a less effective technique would potentially yield conversing results. Wider implications of the findings: This pilot study demonstrated that the usage of the automated sperm selection software SiD gives rise to similar biological outcomes and embryo morphokinetics, indicating its effectiveness in sperm selection. We expect this program would be useful in the presence of less experienced laboratory members helping by standardizing sperm selection.