Objective: To describe the current efforts made to standardize different steps of assisted reproductive technology processes by the introduction of new
technologies for the nonsubjective sperm selection process, oocyte denudation by mechanical removal of cumulus cells, oocyte positioning, sperm motility
screening, fertilization, embryo culture, media replacement by microfluidics, and monitoring of embryo development by time-lapse photography,
embryo secretions, and/or O2 consumption. These technologies could be integrated in a unique and fully automated device.
Design: Pubmed database and research and development data from authors.
Setting: University-affiliated private center.
Main Outcome Measurement(s): None.
Result(s): Several technologies would be useful for: 1) selection of sperm based on viability; 2) manipulation and removal of the cumulus cells' narrow
channel regions combined with microfluidics; 3) advances in oocyte positioning precision through the use of joystick-controlled micromanipulators; 4)
microfluidics allowing the gradual change of a culture medium, which might result in better embryo development as well as reduce the amount of embryo
manipulation; 5) time-lapse, proteomic, and metabolic scoring of the developing embryo, allowing multiple and optimized selection of the embryos. The
technologies described in this review have not yet reported reliable clinical proofs.
Conclusion(s): We already have available some of the technologies described, but we envisage an integrated device, i.e., an IVF lab-on-a-chip, by which
oocyte and sperm would be processed to achieve a perfect embryo ready to be delivered into the uterus. With such a device, sample preparation, chemical
or biologic reactions, and data collection would be integrated.