Maybe once a week, an infertile couple sits in front of me with 500 pages of medical records and a stack of CDs of everything they’ve been through. I know there are valuable trends and relevant observations to discern from this mass of files, but who has the hours to dig through them? AI could do this in seconds. And she could tell me about subtle trends, make diagnoses and suggest rational treatments. By organizing, documenting and analyzing information it would reduce my cognitive load and allow me to think more expansively, as I want. More importantly, and as subtle as a passing glance, AI can expose my cognitive biases, as the brain’s tendency is to process information through the often narrow filter of personal experience and preferences. Yes, machine learning could serve as a second set of eyes on patients. AI, you had me at hello!
E-Skilled Solutionist
The potential for artificial intelligence to help us diagnose the causes of male infertility is huge. AI-assisted visualization of sperm analysis can reduce human error to unprecedented low levels. He can “see” things that we miss simply because we are not very methodical beings. Its intelligent, complex, algorithmic approach can analyze and describe relevant patterns of sperm movement and shape that we cannot always or reliably discern. It can also go “deep” with sperm and help us understand the true meaning behind sperm DNA fragmentation, the genetics, epigenetics, metabolomics and transcriptomics that has us forever puzzled.
Even more exciting is how AI can gather large amounts of health information, including lifestyle, diet, activity, age, medical history, physical exam, and sperm and hormone findings to predict with certainty of a person’s true fertility potential. By doing this, machine learning could reveal to us the rank order of each variable’s effect and its effects on fertility. For example, it would be nice to have more help deciding which patients should have theirs varicocele is surgically repaired to ensure a positive response.
E-Curing Man
I have always said that the best way to be fertile is to live a healthy life. When surrounded by a healthy body, sperm will (generally) run hard and fast. To this end, lifestyle modification is a primary therapeutic goal for improving fertility. Like tailoring a custom suit for you, AI-based apps can provide personalized, evidence-based recommendations on a range of lifestyle topics, including diet, exercise and sleep, that could improve sperm health and fertility. And don’t forget AI-powered wearables, which can track and monitor compliance with prescribed treatment plans and encourage patients to stay on point and stay committed to treatment goals. So I see AI as key to improving patient engagement in ways that are currently not possible. Take obesity for example. It is the elephant in the room as a major, treatable cause of male infertility. AI could provide this critical level of continuous feedback and support to help patients “get over the hump” and on their way to becoming healthier souls.
How AI can help the IVF lab is already pretty clear to many of us in the field. Help choosing sperm for in vitro Procedures using automated microfluidics and imaging could identify the “healthiest” sperm for ICSI. Real-time monitoring of embryo culture conditions can ensure consistency in the laboratory and improve embryo quality. Visualizing developing embryos with the help of machine learning could improve the selection of embryos for transfer and improve pregnancy rates. And mechanically, AI-assisted robotics could handle gametes more consistently and with fewer errors than we humans can. Consider how robotic prostatectomies for prostate cancer have revolutionized urologic care over the past two decades!
Electronic Prediction Results
Even more generally and at the beginning of the infertility journey, by assessing the clinical characteristics of each partner, AI can suggest personalized treatment plans that direct us to what level of assisted reproduction (eg timed intercourse, IUI or IVF) may be work best for them. Who should skip IUI and proceed with IVF in cases of unexplained infertility? Additionally, it could help clinicians choose the best drugs, doses, and timing of hormonal stimulation regimens used in IVF to optimize egg quality and number and reduce side effects, an issue particularly important in older couples. .
Finding new drugs and treatments in the world of infertility is a slow, painstaking and fairly haphazard process that depends heavily on animal experiments and basic science research. Through the ability to analyze big data that encompasses all aspects of science and is based on a deeper understanding of genetic or biochemical pathways, AI can think “outside” to identify new and novel factors that may improve fertility. Also, by modeling how these treatments interact with our physiology, AI can potentially speed up drug development. This is the ultimate goal of precision medicine.
Thus, there is a lot of scope for AI to develop in the field of infertility. Rest assured, however, that it will not replace us humans in medicine. AI is based entirely on historical training sets and is entirely iterative. learns from the past. It is agnostic and amoral and lacks the uniquely human qualities of creativity and emotion. And these qualities, my friends, are the true foundation of medicine. In the words of the venerable Sir William Osler: “The practice of medicine is an art, not a trade. a calling, not a business. a calling in which your heart will be exercised as much as your head.”
