A new AI-powered technology is locating sperm cells in men previously diagnosed as infertile, offering a market-driven solution to couples described as “desperate to conceive” and “vulnerable to being sold expensive treatments of unproven value,” according to Professor Siobhan Quenby of The University of Warwick. The technique, known as the Star (Sperm Track and Recovery) system, was developed by Columbia University and uses artificial intelligence to identify and locate “hidden” sperm in men with azoospermia.
Infertility affects millions globally, with approximately one in every six people of reproductive age experiencing difficulties getting pregnant. Male infertility contributes to up to 50% of these cases, and 1% of all men are azoospermic, meaning their sperm counts are so low that individual spermatozoa are exceedingly difficult to find. This widespread condition creates a significant market for advanced fertility treatments.
Penelope and Samuel, a couple who had battled infertility for an “agonising two and a half years,” illustrate the system’s application. Samuel, diagnosed with Klinefelter syndrome, a genetic condition often leading to azoospermia, had been told he had only a 20% chance of having a biological child. After Samuel underwent hormone therapy for nine months and a testicular extraction surgery at Cornell Medical Center, specialists there could not find sperm with the human eye. The sample was then sent to Columbia for investigation with the Star system.
The Market for Hope
The Star system was able to isolate eight sperm in Samuel’s sample, which were then injected into Penelope’s eggs, resulting in one blastocyst. Their baby, expected at the end of July, is likely the first boy born using this technology. This outcome provides hope for individuals like Samuel, who stated, “I was scared. I thought that I wasn't going to be able to have my own kid, which is a really big part of my life.”
At the end of last year, about 4 months ago, the first baby conceived with the Star system was born to a couple who had struggled with infertility for almost two decades. Zev Williams, director of Columbia University Fertility Center, noted the widespread demand, with the waiting list for the technology growing to hundreds from around the world. Based on the latest 175 patients, the Star system is finding sperm in just under 30% of cases for individuals previously told they had no chance of conceiving with their own sperm.
The technology’s efficiency is a key selling point: Star was able to find 40 times more sperm than a manual search by a trained human technician. This efficiency, while beneficial for patients, also streamlines the process for fertility centers, potentially increasing throughput and profitability within the privatized healthcare system. The system’s development began six years ago, in 2020, when Williams drew inspiration from AI used to find new stars, applying similar machine learning algorithms to detect rare sperm cells in a “sea of all this other debris and cell fragments.”
Technological Advance, Systemic Questions
Beyond sperm retrieval, AI is also being deployed in other areas of fertility treatment, including personalized hormone dosage in ovarian stimulation and more accurate gamete and embryo selection using deep learning tools. These advancements represent a broader expansion of capital-intensive technologies into reproductive health.
However, experts caution that “more large-scale clinical trials are needed to assess long-term outcomes.” Concerns also remain regarding the handling of sensitive medical data, confidentiality, and disputes around accountability and ownership. Dr. Wei Xing, an assistant professor at the University of Sheffield, highlighted the lack of information about which patients the AI might be worse at diagnosing, such as elderly patients or non-English speakers, raising questions about equitable access and potential biases within these market-driven solutions.
Professor Quenby’s warning about desperate couples being “vulnerable to being sold expensive treatments of unproven value” underscores the systemic issue where human needs are met through commodified services, often without full transparency or established long-term safety. While the Star system represents a “genuine step forward” in technological capability, its integration into a system that prioritizes profit over collective well-being means that the promise of hope remains intertwined with the extraction of value from human vulnerability. Samuel’s desire for another child, knowing he would “have to go through this again because we don't have anything in reserve besides eggs,” illustrates the ongoing cycle of reliance on expensive, advanced medical interventions.