LAUSR

Does SiD improve blastocyst quality based on the Gardner grading system, enhance embryo ranking through AI algorithms and increase euploidy rates? The ICSI-SiD group exhibited higher Chloe and iDA scores and a tendency for higher euploidy, with no significant differences in Gardner or KID scores. The development of intracytoplasmic sperm injection (ICSI) has significantly advanced fertility treatments, especially for men with severe infertility. Since the male gamete contributes half of the embryo’s genetic material, male factors are crucial in determining chromosomal integrity. Semen parameters are key indicators of male fertility, directly influencing embryo development and pregnancy outcomes in medically assisted reproduction (MAR). Recent technological advancements and artificial intelligence (AI) have improved outcomes by selecting sperm with optimal motility and DNA integrity. Among these, AI tools such as SiD (Automated Single-Sperm Selection Software) were designed to evaluate and select sperm in real-time based on motility characteristics. A retrospective study of 91 blastocysts with known PGT-A results from 16 patients aged 21–30 was conducted at a private IVF center in Cyprus between March and September 2024. ICSI cycles using ejaculated sperm were included, excluding semen samples with < 5million/ml concentration or < 20% motility. Participants were divided into two groups:Group I (ICSI, sperm selected by embryologists) and Group II (ICSI-SiD, sperm selected using SiD software). Statistical analysis was performed using the chi-square test. Embryos cultured in the Embryoscope underwent biopsy on Day 5, followed by PGT-A. iDAScore values were calculated with version 1.2.0, while the KIDScoreD5 v.3 was determined through morphokinetic parameters in Embryoviewer. The Chloe-EQ Score was assessed via auto-annotated time-lapse videos. Blastocyst quality scores were calculated by multiplying the expansion grade (1–6) by ICM and TE grades (A = 3,B=2,C=1).All biopsied blastocysts had an expansion grade of ≥ 3. This study compared the outcomes of ICSI cycles between two groups: Group I (ICSI only, n = 46) and Group II (ICSI-SiD, n = 45). Fertilisation rates were 81.25% and 81.5%, respectively (p = 0.48), while blastulation rates were 87.1% in Group I and 91% in Group II (p = 0.19). The results indicated that Group II outperformed Group I in certain parameters, showing significantly higher Chloe scores (9.38 ± 1.09 vs. 8.04 ± 2.86, p = 0.004) and iDA scores (7.58 ± 1.58 vs. 6.38 ± 2.51, p = 0.008). However, no significant differences were observed in blastocyst quality scores (29.60 ± 11.58 vs. 27.44 ± 11.54, p = 0.374) or KID scores (7.30 ± 1.50 vs. 6.60 ± 2.34, p = 0.096) between the groups. Although the euploidy rate was higher in Group II compared to Group I (77.8% vs. 67.4%), this difference was not statistically significant (p = 0.267). The small sample size and single-center design underscore the need for further research. Moreover, as the study primarily involved younger patients, future research should include older age groups to determine whether the findings are consistent across different demographics. This study suggests that AI-assisted sperm selection may enhance embryo quality, potentially leading to improved outcomes in fertility treatments. However, further research is required to determine whether these benefits are consistent across different patient groups and to assess its impact on live birth rates and long-term outcomes. No