Reproductive biomedicine online最新文献

As the era of commercial and frequent spaceflight advances, the question of human fertility in space is no longer theoretical but urgently practical. Despite over 65 years of human spaceflight activities, little is known of the impact of the space environment on the human reproductive systems during long-duration missions. Extended time in space poses potential hazards to the reproductive function of female and male astronauts, including exposure to cosmic radiation, altered gravity, psychological and physical stress, and disruption to circadian rhythm. This review encapsulates current understanding of the effects of spaceflight on reproductive physiology, incorporating findings from animal studies, a recent experiment on sperm motility, and omics-based insights from astronaut physiology. Female reproductive systems appear to be especially vulnerable, with implications for oogenesis and embryonic development in microgravity. Male reproductive function reveals compromised DNA integrity, even when motility appears to be preserved. This review examines the limited embryogenesis studies in space, which show frequent abnormal cell division and impaired development in rodents. Alongside physiological findings, this review explores ethical issues of space work, particularly with increasing spaceflights involving non-professional astronauts and individuals of all ages. This convergence of space medicine, reproductive biology and bioethics represents a novel and critical intersection that warrants attention. Drawing from multidisciplinary fields, a collaborative framework is proposed for future research, aiming to catalyse cross-disciplinary dialogue and guide the next generation of reproductive biomedical research in space.

Research question: Can EMBRYOLY, an objectively trained artificial intelligence (AI) system, assist embryologists in embryo assessment when only poor-quality embryos are available for transfer?

Design: Data from 15,767 embryos were collected via EMBRYOLY from 3214 egg retrievals (2019-2024) across 15 clinics (four countries) using three time-lapse systems, including data from seven independent clinics (not used in the original training of the algorithm). EMBRYOLY was used to automatically detect poor-quality embryos. Subsequently, EMBRYOLY's transformer-based model was applied on poor-quality embryos to evaluate agreement with embryologists, ranking performances against clinical pregnancy and live birth outcomes, effect on time to pregnancy and first cycle pregnancy rate. Finally, clinical pregnancy rate was compared between poor versus non-poor embryos recommended for transfer by EMBRYOLY's hybrid model.

Results: For 29% of embryo cohorts, embryologists were faced with only poor-quality embryos available for transfer. EMBRYOLY's first choice of poor-quality embryo was concordant with the embryologists' first choice in 66% of embryo cohorts. EMBRYOLY's score was significantly associated (P < 0.001) with clinical pregnancies and live births on poor-quality embryos. For multiple transfers of poor-quality embryos, the adjunct use of EMBRYOLY could have reduced cycles to pregnancy by 19% and increased first cycle pregnancy rate by 65%. When EMBRYOLY recommended a poor-quality embryo for transfer, it had comparable chances of leading to a clinical pregnancy compared with higher quality embryos.

Conclusions: Objectively trained AI can help embryologists to select poor-quality embryos that can lead to pregnancy, which is crucial when good or fair embryos are unavailable.