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AI tool spots rare sperm in 2.5 million images, helps couple conceive after two decades

AI tool spots rare sperm in 2.5 million images, helps couple conceive after two decades
At eight weeks, the ultrasound showed normal fetal development with a heartbeat of 172 bpm.

AI and fertility: An artificial intelligence system has helped a US couple conceive after nearly two decades of infertility by locating two viable sperm cells in a sample previously deemed azoospermic, according to a correspondence in The Lancet.

The couple, a 39-year-old man and a 37-year-old woman, had undergone multiple IVF cycles and two surgical sperm-retrieval attempts without success. “A semen sample can appear totally normal, but under the microscope, you see a sea of cellular debris, with no sperm visible,” said senior author Zev Williams, director of the Columbia University Fertility Center.

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Researchers tested a new method called Sperm Tracking and Recovery (STAR), which pairs high-powered imaging with AI to perform high-speed, real-time searches for rare sperm. In this case, a 3.5-mL semen sample was processed and scanned; while manual examination found none, the STAR system analysed 2.5 million images in about two hours and identified seven sperm (two motile, five non-motile). Microfluidic channels isolated the target fraction, and a robotic micromanipulator extracted the cells.

The two motile sperm were injected into two mature oocytes, leading to embryo development. On day three, the embryos were transferred; 13 days later, the patient had her first positive pregnancy test, which progressed to a confirmed clinical pregnancy. At eight weeks, the ultrasound showed normal fetal development with a heartbeat of 172 bpm.

Azoospermia affects men whose ejaculate contains little or no sperm; surgical retrieval is often invasive and not always successful. The authors say the single-case result demonstrates feasibility and could reduce reliance on surgery for some patients, though larger clinical trials are underway to determine how broadly STAR can help. “Many couples with male-factor infertility are told they have little chance of having a biological child,” Williams noted, adding that AI may offer a new path forward for at least a subset of them.

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