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Researchers reporting at the American Society for Reproductive Medicine meeting said the AI-powered STAR system detected sperm in 26% of samples from 175 men previously classified as sperm-negative by manual examination. They also reported at least three live births involving sperm recovered with the system, but its performance, accessibility and broader clinical value need further study.
Researchers said an AI-powered sperm detection system found at least one sperm in 26% of samples from 175 men whose azoospermia had been confirmed by manual examination, and that sperm recovered with the tool has been involved in at least three live births. The findings, presented by Hemant Suryawanshi of Columbia University Fertility Center and colleagues at the American Society for Reproductive Medicine’s annual meeting, suggest that some patients classified as sperm-negative may have sperm too rare for conventional examination to detect.
The system, called Sperm Tracking and Recovery (STAR), combines high-speed imaging, real-time artificial intelligence and microfluidic technology. The researchers said it processes about two million images and isolates sperm identified by the AI into a small volume. The recovered sperm may then be considered for fertility treatment, including intracytoplasmic sperm injection (ICSI), or for cryopreservation.
In a test using samples spiked with 40 sperm, researchers divided each sample between STAR and an expert clinician, who each had 60 minutes to find sperm. Across 10 tests, STAR detected sperm in all 10, while the clinician found sperm in three. The researchers reported 167 sperm detected by STAR and four by manual examination. This was a controlled test with sperm added to samples, distinct from the results in patients.
For the patient group, all 175 men had been judged sperm-negative through manual examination before STAR analysis. The team reported that STAR found at least five sperm in 22% of samples and at least 10 in 19%. Among patients who had previously undergone testicular sperm extraction and were still considered sperm-negative, the system detected sperm in 29%, according to the researchers.
A Possible Alternative to Repeat Retrieval
Azoospermia is the absence of sperm in semen on examination, but the results highlight a distinction between no sperm being present and sperm being present at levels too low for a standard search to find. For some couples seeking a biological child, locating even a small number may create an option to discuss with fertility specialists.
The researchers said the usual next step for some men with azoospermia is testicular sperm extraction, including microsurgical extraction. These procedures involve surgery and, according to the source report, fail about half the time. STAR could potentially help identify rare sperm in an ejaculate sample and inform treatment decisions. The meeting results do not establish that the system can replace surgery or improve outcomes for every patient.
Researchers also reported that STAR-recovered sperm had been used in cases resulting in at least three live births, through ICSI or cryopreservation. These reported cases show that the system has been used in clinical care, but they do not by themselves establish how often its use leads to pregnancy or live birth.
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From Lab Test to Patient Samples
Male factors contribute primarily or in part to about half of infertility cases, the researchers said, and they estimated that 10% to 15% of infertile men have azoospermia. The meeting report focused on whether sperm that is difficult to see with manual microscopy might still be recovered from some samples.
One previously reported case involved a man who had undergone testicular sperm extraction twice. STAR identified sperm in his ejaculate; after a 19-year history of infertility, the couple had a live birth in December 2025. The case was reported as correspondence in The Lancet, according to MedPage Today. Suryawanshi said two other live births occurred in July 2026 and October 2026.
The patient findings were reported at a professional meeting, and the available account does not provide a full study paper or detailed comparison of STAR-guided care with standard treatment. The controlled spiked-sample experiment and the consecutive-patient results are separate types of evidence and should not be treated as interchangeable.
“A substantial number of these patients have rare sperm, and the limitation is not the biological absence of sperm for these cases, it’s actually our lack of ability to detect the sperm.”
— Hemant Suryawanshi, PhD, of Columbia University Fertility Center, speaking to MedPage Today
Limits on Access and Evidence
The findings do not establish STAR’s overall accuracy across clinics or how often detection will lead to pregnancy or live birth. The meeting report provides results from 175 patients but does not give a randomized comparison, detailed patient outcomes for the full group, or a comparison of treatment success against standard approaches. The live births are important reported outcomes, but the number is small and does not show a success rate.
STAR also currently requires a highly trained technician, Suryawanshi said. The researchers are working on a simpler version, while other groups are developing similar tools. It is not clear when a more accessible version might be available, what it would cost, or which patients would be suitable. A positive result also does not guarantee that enough sperm will be available for treatment.
Simpler Testing and Further Validation
Suryawanshi’s team is working to make STAR easier to operate, according to the meeting report. Wider use would depend on whether the system can be run reliably beyond specialist settings and whether additional research confirms its ability to find sperm and support meaningful treatment outcomes.
For now, men with azoospermia and their partners should discuss testing and treatment choices with a qualified fertility specialist. The reported results offer a possible additional detection approach, but they do not establish a change to standard care or a substitute for individualized medical advice.
Key Questions
What is the STAR system?
STAR is a sperm detection and recovery tool that uses high-speed imaging, real-time AI and microfluidic technology to identify and isolate sperm from a sample.
How often did STAR find sperm in the patient samples?
Researchers said STAR detected at least one sperm in 26% of 175 samples from men previously classified as sperm-negative by manual examination. This result does not mean that every detected sperm can be used successfully in treatment.
Did the system lead to live births?
The researchers reported at least three live births involving sperm recovered with STAR, used for ICSI or cryopreservation. The report does not provide a live-birth rate for all patients tested.
Can STAR replace testicular sperm extraction?
The reported findings do not establish that STAR can replace testicular sperm extraction. Its suitability and the next steps depend on individual circumstances and should be discussed with a fertility specialist.
Is STAR widely available?
The report says the system requires a highly trained technician. Researchers are working on a simpler version, but availability, cost and timing were not reported.
Source: rss
