At the Brigham and Women’s Hospital (BWH) Connors Center for Women’s Health, the cries of healthy babies are a typical day’s soundtrack—but these sweet sounds often belie the deeper struggles women and families can experience on the road to parenthood. To forge a smoother path, researchers here are using high-tech imaging to shine new light on the mechanisms driving premature birth brain injury and fertility treatment outcomes.

The office of Catherine Racowsky, PhD, Director of BWH’s Assisted Reproductive Technologies Laboratory, is covered with photos of babies first glimpsed as embryos—a constant reminder of her mission to improve the results of in vitro fertilization (IVF) for patients. “I still get goosebumps when I see a human embryo through the microscope,” she says.

To solve the mysteries that remain around the IVF journey from embryo to live birth, Racowsky is harnessing fluorescence lifetime imaging microscopy and genetic sequencing to observe mitochondrial function in eggs and embryos. She recently received a National Institute of Health grant for this research in partnership with Dan Needleman, PhD, of Harvard University, and Dagan Wells, PhD, of the University of Oxford. The views of mitochondrial activity could help embryologists better predict which eggs and embryos will produce healthy babies—a prediction impossible with the eye alone.

“When we look at our data, we see that lower quality embryos are sometimes capable of producing full-term babies,” explains Dr. Racowsky. “It’s unlikely we’ll ever have just one test for evaluating embryos—I suspect we’ll end up with a three- or four-prong approach, one of which may be the imaging technology we’re investigating.”

Once pregnancy is achieved, the focus turns to bringing the pregnancy to full-term, or 40 weeks. Yet one in 10 U.S. babies are born prematurely—putting them at risk for brain injury. To better track such injuries, Terrie Inder, MD, PhD, MBChB, Chair of BWH’s Department of Pediatric Newborn Medicine, is building a databank of brain scans much like those that elucidate adult brain disease and injury. A study by Dr. Inder revealed that just 15 percent of babies with signs of brain conditions had their brains imaged.

“If you’re an adult who comes to the doctor with these symptoms, what are the chances they don’t look at your brain? Zero,” explains Dr. Inder. “Defining the presence of brain injury in babies when they go home from the hospital is critically important to effective care and rehabilitation.”

For nearly 20 years, Dr. Inder has been using magnetic resonance imaging (MRI) scans to quantify these brain injuries in premature babies. She recently partnered with the BWH Department of Radiology to install a special MRI in the Newborn Intensive Care Unit, designed to enhance the ease of imaging the tiniest brains. The scanner will be installed this summer.

“We know the difference this kind of knowledge makes in helping adults recover—imagine the effect it can have on a tiny baby,” notes Dr. Inder. “To improve their future, we have to be willing to look.”

Read more about other BWH imaging research in the Brigham Health magazine.

Topics: Technology, Innovation, Academic Medical Centers

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