The Clinical Embryologist: Past, Present and Future Challenges

Abstract

Embryologist is an essential part of infertility care defined as a highly skilled and well-trained person who can work in teamwork to execute continuous tasks with near-zero error and pay attention to detail with excellent clinical judgment. At the very beginning, embryologist’s routine daily tasks were quite simple including processing the sperm and eggs for natural insemination. Following that, advanced infertility treatment emerged quickly including intracytoplasmic sperm injection (ICSI), vitrification-warming, embryo shipping, intracytoplasmic morphologically sperm injection (IMSI), as well as trophectoderm biopsy as a source of chromosomal copy number testing or monogenic disorders analysis. Collectively, the implementation of such improved treatments renders complexity in the IVF laboratory that could be simplified in the future. Apparently, the implementation of advanced technology in the field of IVF nowadays has two main purposes. The first is to improve the IVF success rate including finding precise markers for embryo selection such as genomics, proteomics, and metabolomics fingerprint and images-based artificial intelligence algorithm for embryo selection. The second is to standardize or simplify routine daily tasks in the embryology laboratory by implementing automated software such as for laboratory quality control maintenance, a microfluidic system that allows standardization of handling gametes, micro-robotic for immobilizing sperm for ICSI, fully automated semen analysis, electronic tagging of laboratory devices to improve traceability. All such automated systems will serve as advanced clinical decision tools to boost IVF success rate and infertility care quality. An elevated automated system in the future in an embryology laboratory would impact the clinical embryologist in terms of reduced quantity and conversely, increased qualities of highly scientific embryologists with proper education. Embryologist roles may change from conventional routine daily tasks to well-trained and experienced embryologists who are able to scientifically evaluate the effectiveness of certain approaches or potential clinical use of such implementation in their clinical laboratory setting.