Evidence map›Paper›PMID 42449562›Full record

ReviewHuman reproduction (Oxford, England)2026

Metabolic imaging for gamete and embryo assessment through advanced microscopy technologies: a novel avenue for artificial intelligence?

Fabrizzio Horta, Denny Sakkas, Shannon Handley, Yaoxi Xiong, Bettina Mihalas, Rebecca Deans, Roger J Hart, Robert B Gilchrist, Ewa M Goldys

Abstract readReview
In one paragraph

Review in Human reproduction (Oxford, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Fabrizzio HortaFertility & Research Centre, Discipline of Women's Health, School of Clinical Medicine and the Royal Hospital for Women, University of New South Wales, Sydney, NSW, Australia.ORCID 0000-0003-3212-4924
Denny SakkasBoston IVF, IVIRMA, Global Research Alliance, Waltham, MA, USA.ORCID 0000-0002-9509-6791
Shannon HandleyGraduate School of Biomedical Engineering, ARC Centre of Excellence for Nanoscale BioPhotonics, University of New South Wales, Sydney, NSW, Australia.ORCID 0009-0009-3242-125X
Yaoxi XiongFertility & Research Centre, Discipline of Women's Health, School of Clinical Medicine and the Royal Hospital for Women, University of New South Wales, Sydney, NSW, Australia.ORCID 0000-0003-4081-4183
Bettina MihalasFertility & Research Centre, Discipline of Women's Health, School of Clinical Medicine and the Royal Hospital for Women, University of New South Wales, Sydney, NSW, Australia.ORCID 0000-0002-6006-8475
Rebecca DeansFertility & Research Centre, Discipline of Women's Health, School of Clinical Medicine and the Royal Hospital for Women, University of New South Wales, Sydney, NSW, Australia.ORCID 0000-0001-7932-550X
Roger J HartCity Fertility, Research Support Unit, Sydney, NSW, Australia.ORCID 0000-0002-6610-3040
Robert B GilchristFertility & Research Centre, Discipline of Women's Health, School of Clinical Medicine and the Royal Hospital for Women, University of New South Wales, Sydney, NSW, Australia.ORCID 0000-0003-1611-7142
Ewa M GoldysGraduate School of Biomedical Engineering, ARC Centre of Excellence for Nanoscale BioPhotonics, University of New South Wales, Sydney, NSW, Australia.ORCID 0000-0003-2470-7118

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Infertility affects approximately one in six people globally and demand for ARTs, is expected to rise as parenthood is increasingly delayed. However, ART success remains constrained by gamete and embryo quality, female age, and biological factors beyond chromosomal status alone, highlighting the need for non-invasive methods that can complement current morphology-based and genetic approaches. Because gamete and embryo developmental competence is tightly coupled to cellular metabolism, label-free metabolic imaging has emerged as a promising strategy to assess developmental potential through endogenous autofluorescence of reduced nicotinamide adenine dinucleotide/phosphate [NAD(P)H] and oxidized flavins (FAD), which provide optical proxies of redox balance, mitochondrial activity, and oxidative metabolism. This invited mini-review synthesizes the biochemical basis of NAD(P)H/FAD autofluorescence signals, relates these readouts to the unique metabolic programs of oocytes, embryos across preimplantation development, and sperm, and reviews reproductive studies using fluorescence lifetime imaging microscopy, hyperspectral microscopy, and emerging light-sheet fluorescence microscopy. We discuss practical and interpretive challenges, including modality-dependent signal biases and recent consensus efforts towards standardization. Evidence linking metabolic signatures to reproductive ageing, developmental potential, and embryo ploidy status suggests that metabolic imaging, particularly when paired with artificial intelligence (AI), could enable automated, objective decision support for gamete and embryo selection. Finally, we briefly outline how AI could convert complex metabolic imaging data into clinically interpretable decision-support outputs for embryo ranking and risk stratification. Advances in rapid volumetric imaging, microsystems, and AI may support future ART workflows aimed at improving efficiency, accessibility, and cost-effectiveness.

Indexed as

Artificial IntelligenceGerm CellsEmbryonic DevelopmentFemaleHumansMaleMicroscopy, FluorescenceNADPOocytesReproductive Techniques, AssistedSpermatozoaNADPARTembryosmetabolic imagingmetabolismmicrosystemsoocytesperm

Identifiers

PMID42449562
PMCPMC13550671

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.