AI, Embryo Screening, And The Future Of IVF In India

Reproductive Medicine has transformed at a much faster pace. During the last four decades, the ART field has moved to more precise, personalised and evidence-based treatments. The patient safety and patient care have also improved in the last decade. The Assisted Reproductive Technology (ART) Act, 2021 of India also has brought in the much-needed regulations which focusses on transparency in the ecosystem for patients and donors. Artificial Intelligence technologies, advanced embryo evaluation and genetics are making their way into this change and India is poised to influence the future of reproductive medicine. Studies report that at least 1 in 6 couples in India experience infertility. Social and demographic tendencies also play a role in changing the composition of patients in fertility centres in metros and tier 2 regions. It is also important to understand that the most difficult issues faced by couples in India is not the access to technology, but delayed access to fertility care. Often, couples visit a fertility specialist after multiple unsuccessful attempts to conceive a baby naturally. Artificial intelligence is one of the most important innovations in the rapidly changing world of reproductive science. It is used in both embryo and sperm selection. It is shifting the assessment from a largely observational process to a more data-enriched one, which can help specialists identify subtle patterns and variations that may have previously been difficult to quantify. One of the major advantages of AI is its ability to analyze large numbers of sperms within a short period and detect subtle patterns that may not always be obvious during manual assessment. What is crucial to understand is Artificial Intelligence is not replacing embryologists, instead, it serves as an additional tool that supports embryologists' observations and helps them make more informed decisions. AI can bring greater consistency to assessments by reducing subjectivity and ensuring sperm and embryo evaluation is based on objective, measurable parameters. However, the technology does come with its limitations. Artificial intelligence predicts probabilities but cannot predict the outcome. Successful implantation and live birth continue to depend on multiple biological variables, including maternal age, ovarian reserve, uterine receptivity, sperm quality, embryo genetics and underlying medical conditions. AI is therefore best regarded as a decision-support tool that complements, rather than replaces, clinical expertise. Time-lapse embryo tracking systems offer the capacity to monitor embryo development without interrupting the laboratory environment and enhance embryo selection actions and accuracy. By using advanced techniques and placing more importance on precision, fertility clinics like us are moving into more of single embryo transfers, which are much safer in advanced maternal age group of patients. Apart from AI, preimplantation genetic testing also plays an important role in embryo selection and further personalisation of treatment in selected patients. Chromosomal abnormalities can also cause implantation failure and recurrent pregnancy losses. Preimplantation Genetic Testing for Aneuploidy (PGT-A) is a tool allowing chromosomal assessment of embryos before their transfer. PGT- M is also used to determine embryos carrying genetic disorders. Women at advanced reproductive age, people suffering from recurrent miscarriages, implantation failures and people with balanced chromosomal rearrangements benefit from genetic testing after proper consultation. It should also be noted that preimplantation genetic testing is a screening test but not a diagnostic test and the results must be understood within the context of a wider clinical scenario.