Part 4 - Embryology in the 21st Century: Breakthroughs and Innovations

Robotic Technology & Gene Editing in IVF

Michael B. Yakass, Ph.D.

Robotic Technology

Several medical and laboratory tasks can sometimes be repetitive and to free embryologists from these repetitive tasks to focus on the more complex techniques required in IVF, robotic technology is on the rise in the IVF industry. Trials are currently being performed on micro-fluidic systems to automate the embryo vitrification process which has demonstrated comparable results of survival and embryo development when compared to human performed vitrification (Brunetti et al., 2021; Miao et al., 2022). These robotic technologies are not currently in mainstream IVF clinics but there are some trials in experimental settings to improve the precision, accuracy and reproducibility of these robotic techniques. In fact, there are reports of birth of the first IVF babies resulting from robotic ICSI. Yes, the ICSI was performed by a robot that had sperms loaded into it to directly inject matured eggs and deposit a single sperm into these eggs. Robotic technologies is still far from fully automating the IVF processes but robotic ICSI and vitrification is a step that is receiving some attention nowadays.

Gene Editing in IVF

Gene editing, particularly through technologies like CRISPR-Cas9, will revolutionize IVF and personalized medicine. Gene editing involves precise modifications to an organism's DNA. In the context of IVF, this process can occur at the embryonic stage, enabling the correction of genetic abnormalities before implantation. The most widely discussed tool for this purpose is CRISPR-Cas9, a technology that allows for highly specific targeting and alteration of DNA sequences. 

Perhaps the most practical demonstration of how gene editing can revolutionize personalized medicine was in 2018 when Prof. He Jiankui in China, used the CRISPR-Cas9 gene editing system to edit the CCR5 gene in human embryos. CCR5 is a gene that makes the coreceptor required for HIV to infect cells. With CCR5 edited in human embryos, the resulting babies lack a functional CCR5 and hence remain resistant to HIV infection for life. Despite its promise, the use of gene editing in IVF is fraught with ethical and technical challenges. The possibility of off-target effects, where unintended parts of the genome are altered, poses significant risks. Furthermore, the long-term effects of gene editing on human embryos are still not fully understood, necessitating extensive research and stringent regulation. Ethically, the prospect of 'designer babies'—where parents might choose non-medical traits such as intelligence or physical appearance—raises profound moral questions. This potential misuse of technology prompts a need for robust ethical guidelines and policies to ensure gene editing is used responsibly and equitably.

In this series of 6 articles, we will take a daily look at some of the most recent advancements and innovations (in no particular order) in this rapidly growing field of medicine.