The first one was obtained pregnancy in the world in a couple with a history of infertility using spermatozoa identified and isolated by a system that uses theartificial intelligence. The platform developed by researchers at the Columbia University Fertility Center is called STAR (Sperm Tracking and Recovery) and allowed us to recover the rare motile spermatozoa of a 39-year-old man suffering from azoospermia (absence of sperm in the ejaculate) and to successfully implant them into the oocytes of the female partner (37 years old) who suffered from severely reduced ovarian reserve – decreased number and/or quality of oocytes in the ovaries. The case of pregnancy, so far thethe only one recorded in the literaturewas reported by researchers in a research letter published on The Lancet: it is not a complete scientific article but a concise scientific communication reporting new preliminary or early-stage discoveries, with a shorter length and faster publication time. The actual effectiveness of the promising STAR platform will be evaluated in larger clinical trials.
It took Dr. Zev Williams, the lead author and director of the Columbia University center, about 5 years to develop this system that combines an artificial intelligence algorithm with a microfluidic chip – a coin-sized device with microchannels to control the flow of small volumes of liquid. To understand how it works you need to understand that in a sample of normal sperm There are millions of sperm per milliliterwhile in a patient suffering from azospermia, a condition present in approximately 10% of infertile men, there could also be only two or three. Hence the need to have an innovative and very precise method to be able to capture and isolate those very few viable cells.
The STAR system is an ultra-high-power imaging technology that combines microfluidics and AI in a non-invasive technique capable of processing up to 1.1 million images per hour. In the case study in question, STAR scanned a 3.5 ml sample of the patient’s semen, in which themanual examination did not detect any sperm, and generated 2.5 million images in 2 hours. This analysis allowed the system to identify and recover seven spermatozoa (two mobile and five immobile). The two mobile and viable ones were used to fertilize two oocytes with PMA techniques, which both developed into embryos.
In practice, with this technique the ejaculate is passed into the tiny channels of the STAR chip and, if the artificial intelligence detects a mobile and viable sperm, it directs it to a separate tube to be collected. At this point the few “isolated” can be preserved, frozen or used for fertilize an egg. The entire system is completely closed to ensure safety and avoid contamination, all components that come into contact with the sample are disposable.
The transfer of both embryos produced with the help of the STAR system led to first positive pregnancy ever for the couple Americana, confirmed by an ultrasound at 8 weeks showing normal fetal development. It was in fact a couple with one 19 year history of infertility who had already attempted several techniques: for example, the female partner had coped well 19 egg retrieval cycles in four different fertility centers without success. This case, although unique, demonstrates that STAR technology can offer new hope and an alternative non-invasive for couples diagnosed with previously intractable infertility.
