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Researchers reported that the AI-powered Sperm Tracking and Recovery system detected at least one sperm in 26% of samples from 175 men previously found to have azoospermia by manual examination. The team also reported at least three live births involving sperm recovered with STAR, but the findings are early and the system requires a highly trained technician.
Researchers reported that an AI-powered sperm detection system found at least one sperm in 26% of samples from 175 men whose samples had been classified as sperm-negative through manual examination. The Sperm Tracking and Recovery system, or STAR, has also been used to identify sperm associated with at least three live births, according to researchers presenting the results at the American Society for Reproductive Medicine annual meeting.
In a test using samples deliberately mixed with 40 sperm, STAR detected sperm in all 10 trials. An expert examining comparison samples manually found sperm in three of the 10 trials. Across those tests, STAR detected 167 sperm, while manual examination found four. The researchers described that difference as 41-fold; the results came from this specific spiked-sample experiment, not a general measure of clinical performance.
The team also analyzed samples from 175 consecutive patients, with a median age of 36. All had previously been deemed sperm-negative by manual examination. STAR detected at least one sperm in 26% of the samples; the researchers reported at least five sperm in 22% and at least 10 in 19%. In a subgroup that had undergone testicular sperm extraction but remained classified as sperm-negative, STAR detected sperm in 29% of samples.
Hemant Suryawanshi, PhD, of Columbia University Fertility Center and colleagues said sperm identified by STAR had been used for intracytoplasmic sperm injection, or preserved by cryopreservation, in cases leading to at least three live births. One couple had experienced infertility for 19 years; STAR found sperm in the man’s ejaculate after he had undergone testicular sperm extraction twice. The couple had a live birth in December 2025, the researchers said. The other two births occurred in July 2026 and October 2026, according to Suryawanshi.
A Possible Alternative to Repeat Surgery
Azoospermia is the absence of sperm in ejaculate on standard testing. For some men, sperm may be present in very small numbers and escape detection, a distinction that can affect whether biological parenthood remains an option. The researchers said STAR may help locate sperm that could be used in fertility treatment, including intracytoplasmic sperm injection, which uses a single sperm to fertilize an egg.
For couples whose testing finds no sperm, a next step may be testicular sperm extraction, a procedure that retrieves sperm surgically from the testes. The source report says these procedures fail about half the time and can be painful. STAR is being studied as a way to search ejaculate samples for rare sperm, but the findings do not establish that it can replace surgery, improve outcomes for all patients, or guarantee a pregnancy.
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How STAR Searches Samples
The STAR system combines high-speed imaging, real-time AI and microfluidic technology. According to the researchers, it captures and evaluates about two million images, then isolates sperm identified by the software into a small volume. The technology is designed to find cells too rare to be reliably detected through standard manual review.
The study addressed two different questions: whether STAR could find sperm in samples with a known, very low sperm count, and whether it could detect sperm in samples from patients previously labeled sperm-negative. The first was a controlled comparison using spiked samples; the second involved patients referred for STAR analysis. The results from these groups should not be treated as interchangeable measures of accuracy or patient benefit.
“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, speaking to MedPage Today
Limits of Detection and Access
The meeting report does not establish how often STAR’s detections lead to successful fertilization, pregnancy or live birth across a larger patient group. The three reported live births are important clinical outcomes, but they do not by themselves show the system’s overall success rate. The report also does not provide a comparison of STAR-guided care with standard treatment across randomized or otherwise matched groups.
STAR currently requires a highly trained technician to operate, Suryawanshi said. The team is working on a simpler version, while other groups are developing similar tools. How widely available the system is, what it costs, and how its performance varies across laboratories and patient populations remain unclear.
Simplifying the Testing Process
The researchers said they are working to make STAR easier to operate. Further evaluation will be needed to clarify how consistently the system detects sperm in routine clinical settings and how those findings affect treatment decisions and reproductive outcomes. The source report does not specify a timetable for a simplified version or for additional studies.
For now, the results are a meeting presentation and an early report of clinical use, rather than evidence that STAR is a standard replacement for existing fertility testing or surgical retrieval. Patients considering testing or treatment should discuss their circumstances and available options with a qualified fertility specialist.
Key Questions
What is STAR?
STAR stands for Sperm Tracking and Recovery. It combines imaging, AI analysis and microfluidics to search samples for very rare sperm and isolate those detected.
How often did STAR find sperm in the patient samples?
Among 175 samples from men previously classified as sperm-negative by manual examination, researchers reported that STAR found at least one sperm in 26%. This figure is from the reported patient group and is not a general success rate for fertility treatment.
Does STAR guarantee a pregnancy or live birth?
No. Researchers reported at least three live births involving sperm identified by STAR, but the findings do not show that the system guarantees pregnancy or establish a live-birth rate for patients who use it.
Could STAR replace testicular sperm extraction?
The report does not establish that STAR can replace testicular sperm extraction. It searches ejaculate samples for rare sperm, while testicular sperm extraction retrieves sperm surgically from the testes; clinicians would need to determine appropriate options for each patient.
Source: medpagetoday.com
