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Researchers reported that the AI-powered Sperm Tracking and Recovery system detected sperm in 26% of samples from 175 men previously judged sperm-negative by manual examination. The researchers said sperm identified by STAR has been used in treatment associated with at least three live births; the findings do not establish how often the tool improves outcomes overall.
Researchers presenting at the American Society for Reproductive Medicine annual meeting said an AI-powered system detected sperm in 26% of samples from 175 men whose samples had previously been judged sperm-negative by manual examination. The Sperm Tracking and Recovery system, or STAR, has also been used to identify sperm involved in treatment resulting in at least three live births, the researchers reported; the findings do not show how often the system will lead to pregnancy or birth across a broader patient population.
In a controlled test, researchers added 40 sperm to each azoospermia sample, divided the samples between STAR and an expert clinician, and gave both up to 60 minutes to find sperm. The test was repeated 10 times. STAR detected sperm in all 10 samples, while the clinician detected sperm in three. Across those tests, STAR identified 167 sperm, compared with four found manually. The researchers reported this as a 41-fold difference in the sperm count detected in that specific experiment.
The team also examined samples from 175 consecutive patients, with a median age of 36. All had been classified as sperm-negative through manual examination before STAR analysis. The system detected at least one sperm in 26% of samples; the researchers said it found at least five sperm in 22% and at least 10 in 19%. Among patients who had undergone testicular sperm extraction and remained classified as sperm-negative, STAR detected sperm in 29% of the cohort.
According to Hemant Suryawanshi, PhD, of Columbia University Fertility Center and colleagues, sperm detected by STAR has been used for intracytoplasmic sperm injection, or preserved by cryopreservation, in cases associated with at least three live births. One reported case involved sperm found in the ejaculate of a man who had undergone testicular sperm extraction twice. The couple had a 19-year history of infertility and had a live birth in December 2025. The researchers said two other births occurred in July and October 2026.
A Possible Alternative to Surgery
For couples seeking a biological child when a man is diagnosed with azoospermia, finding sperm can affect which fertility options are available. Researchers said the usual next step may be testicular sperm extraction, including microsurgical extraction, which involves surgery to retrieve sperm from the testes. The source report says the procedure can be painful and fails about half the time.
STAR is intended to search semen samples for ultra-rare sperm that may evade manual inspection, potentially identifying sperm without a surgical retrieval procedure in some cases. That possibility is relevant to patients who have been told no sperm were found, but the reported detection results do not prove that STAR can replace surgery or that every sperm it detects can be used successfully in treatment. The three reported births are important examples, not a measure of the system’s general success rate.
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How STAR Searches Samples
Azoospermia describes the absence of sperm in semen under the examination used for diagnosis. The researchers noted that sperm may be present in very small numbers and escape detection through manual examination. Their report says about 10% to 15% of infertile men have azoospermia; it also describes male factors as primary or contributing factors in about half of infertility cases.
STAR combines high-speed imaging, real-time AI and microfluidic technology. According to the report, it captures and assesses two million images, then isolates sperm identified by the system into a small volume. The researchers presented both the spiked-sample comparison and results from referred patients at the ASRM meeting. A separate report on one of the live-birth cases appeared as correspondence in The Lancet, according to MedPage Today.
“What this data shows is that 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 — and systems like STAR are trying to overcome that limitation.”
— Hemant Suryawanshi, PhD, Columbia University Fertility Center, speaking to MedPage Today
Limits of the Current Evidence
The report does not provide a comparison showing how STAR performs across different clinics, operators or patient groups, and it does not establish the system’s overall sensitivity or specificity in routine use. Detection in a sample also does not guarantee that enough viable sperm will be available for treatment, or that treatment will result in pregnancy or live birth. The three reported live births are outcomes described by the research team, not a success rate for all patients tested.
The researchers identified usability as a limitation: STAR requires a highly trained technician. The report does not specify how much the system costs, whether it is broadly available, or when a simpler version might be ready. It also does not say how clinicians should use the results to decide between further testing, sperm retrieval and assisted reproduction.
Simpler Operation and Further Study
Suryawanshi said his team is working on a simpler version of STAR, while other research groups are developing similar tools. The source report does not give a launch date or say when the system could become available outside the settings using it now.
Further evaluation would need to clarify how reliably STAR detects usable sperm in routine clinical practice and how its results affect treatment decisions and patient outcomes. For now, the meeting findings offer evidence that the system detected sperm missed by manual examination in some samples, while its wider clinical role remains unsettled.
Key Questions
What is STAR?
STAR is an experimental sperm-detection system that combines high-speed imaging, real-time AI and microfluidics to identify and isolate sperm in a sample, according to the researchers.
How many samples from the patient group contained sperm detected by STAR?
The researchers said STAR detected at least one sperm in 26% of samples from 175 men who had been classified as sperm-negative by manual examination. This is a finding from the reported patient group, not a result that applies to every person with azoospermia.
Does STAR mean surgery is no longer needed?
No. The findings do not establish that STAR can replace testicular sperm extraction. The system detected sperm in some semen samples, but its role in treatment decisions and its performance in wider clinical use remain unclear.
Has sperm found by STAR been used in successful pregnancies?
The researchers reported that sperm found by STAR was used in treatment associated with at least three live births, including use in intracytoplasmic sperm injection or cryopreservation. The report does not provide an overall live-birth rate for people tested with the system.
When could STAR become more widely available?
The team said it is developing a simpler version, but the report gives no timetable for broader availability. STAR currently requires a highly trained technician to operate.
Source: rss
