The Latest Technologies in IVF and ICSI

The Latest Technology in IVF and ICSI: What It Offers Patients, and How a Fertility Specialist Keeps Up

In short: IVF laboratories are changing faster than ever. Artificial intelligence, time-lapse incubators, gentler injection techniques and new ways of choosing sperm and embryos are already in use, and the first babies have been born after fully automated ICSI and after mitochondrial donation. But not every new technique improves the chance of a baby. A good fertility specialist keeps learning continuously, uses what the evidence supports, explains honestly what is still experimental, and does not sell “add-ons” that are not proven.

When a couple starts IVF today, much of what happens in the laboratory did not exist twenty years ago. Some of these advances have clearly improved results; others are promising but unproven. Knowing the difference is part of the doctor’s job, and it matters directly to the couple: their time, their money, their hopes and, above all, their chance of taking a baby home.

What has changed in the IVF laboratory

1. Freezing eggs and embryos (vitrification)

Ultra-rapid freezing, called vitrification, means that most eggs and embryos survive thawing. This has made egg freezing a real option for women who want to preserve their fertility, allows all embryos to be frozen when the ovaries are over-stimulated, and lets the transfer be planned when the uterine lining is at its best.

2. Time-lapse incubators and artificial intelligence for embryos

Time-lapse incubators photograph each embryo every few minutes without taking it out of its stable environment. Artificial intelligence programs then analyse thousands of images to help the embryologist grade the embryos and choose which to transfer first. These tools make assessment more consistent and less disturbing for the embryo. However, large studies have not yet shown that they increase the chance of a live birth, so they support the embryologist’s judgement rather than replace it.

3. Better ways of choosing and injecting sperm

For male-factor infertility, the laboratory can now select sperm more carefully: microfluidic chips that imitate the natural path of sperm and favour those with less DNA damage, high-magnification selection (IMSI) and physiological selection (PICSI). Piezo-ICSI uses a gentle vibration instead of a sharp needle to enter the egg, aiming to protect more eggs during injection. Our articles on [Piezo-ICSI](/piezo-icsi-advanced-microinjection-technology-for-higher-fertilization-rates-and-improved-oocyte-survival/) and [microfluidic sperm sorting](/microfluidic-innovation-for-sperm-sorting-mfssi/) explain who may benefit. For several of these methods, the evidence that they raise birth rates is still limited, so they are offered to selected couples, not to everyone.

4. Genetic testing of embryos

Preimplantation genetic testing can identify embryos carrying a known inherited disease in the family, and can check embryos for an abnormal number of chromosomes. Researchers are also developing “non-invasive” tests that analyse the fluid in which the embryo grows, without taking cells from it. These tests are still being evaluated and are not yet a replacement for standard testing.

5. Automation and robotics

In 2025 the first babies were born after ICSI performed by a largely automated, AI-guided system, in which most of the steps of the injection were carried out by machine. This is an important proof of principle. It will take time and larger studies before such systems become routine, but they point to a future of more standardised laboratory work.

6. New frontiers

In 2025 doctors in the United Kingdom reported eight babies born after mitochondrial donation, a tightly regulated technique that prevents a mother from passing on a serious mitochondrial disease. Scientists are also working on making eggs and sperm from other cells in the laboratory (in vitro gametogenesis). This remains research only and is not available to patients anywhere.

Not every new technology is a better technology

Many clinics around the world offer optional extras, often called “add-ons”, at additional cost. The UK fertility regulator (HFEA) publishes a rating for each add-on, and for most of them there is not yet good evidence that they increase the chance of having a baby. A responsible specialist uses a new technique when there is evidence it helps, or within a clear explanation that it is still being studied, and never promises a result that the research does not support.

How a fertility specialist keeps up

Medicine in this field moves every year. A specialist who stopped learning five years ago is already treating patients with yesterday’s knowledge. Keeping up requires a deliberate routine:

·       Following international guidelines: those of the European Society of Human Reproduction and Embryology (ESHRE), the American Society for Reproductive Medicine (ASRM), and, since November 2025, the first World Health Organization guideline on infertility.

·       Reading the main journals regularly, such as Human Reproduction, Human Reproduction Update, Fertility and Sterility and Reproductive BioMedicine Online, with alerts set for new studies.

·       Relying on high-quality reviews of the evidence, especially the Cochrane Gynaecology and Fertility reviews, rather than on advertising or single small studies.

·       Attending scientific meetings, such as the ESHRE and ASRM annual congresses, and their online courses and webinars.

·       Training the whole team: embryologists, nurses and doctors learn new techniques together, with hands-on courses and quality-control programmes.

·       Auditing the clinic’s own results honestly, measuring laboratory performance against international indicators, and changing practice when the results call for it.

·       Learning to read research critically: how large the study was, whether it was randomised, and whether it measured live births rather than just positive tests.

What happens when a specialist does not keep up

The cost of not keeping up falls on the patient. It can mean using a stimulation protocol that has been replaced by a safer one, missing a treatment that would suit a particular couple, repeating cycles that could have been avoided, or the opposite: paying for expensive techniques that have no proven benefit. Up-to-date knowledge is not a luxury in IVF; it is part of giving each couple their best chance.

Our approach

Dr. Najeeb Layyous is a member of the European Society of Human Reproduction and Embryology and of the Cochrane Menstrual Disorders and Subfertility Group, and follows international guidelines and research closely. We adopt new techniques when the evidence supports them, explain openly what each option can and cannot do, and choose the treatment plan for each couple individually. To learn how we judge the quality of an IVF programme, read our article on [the six pillars of IVF excellence](/beyond-the-positive-test-the-6-pillars-of-ivf-excellence/).