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Researchers reported that the Sperm Tracking and Recovery (STAR) system detected sperm in samples from some men previously classified as sperm-negative, including 26% of 175 patients studied. The team also reported at least three live births involving sperm recovered with STAR, but the findings do not establish how often the method leads to pregnancy or whether it will be widely available.
Researchers reported that an AI-assisted system called Sperm Tracking and Recovery (STAR) detected at least one sperm in samples from 26% of 175 men previously classified as sperm-negative by manual examination. Presented at the American Society for Reproductive Medicine’s annual meeting, the findings suggest the tool may identify sperm that conventional searches miss; researchers also said STAR-assisted recovery has been involved in at least three live births.
In a laboratory comparison, investigators added 40 sperm to samples from men with azoospermia, divided each sample between STAR and an expert, and gave both 60 minutes to search. Across 10 tests, STAR detected sperm in all 10 samples, while the clinician detected sperm in three. The system found 167 sperm in total, compared with four found manually. These were deliberately prepared samples, so the comparison does not by itself show how the tool performs in every clinical setting.
The researchers then reported results from 175 consecutive patients, with a median age of 36, whose samples had been called sperm-negative on manual examination. STAR detected at least one sperm in 26% of samples; the team said it found at least five sperm in 22% and at least 10 in 19%. Among patients who had undergone testicular sperm extraction and were still classified as sperm-negative, STAR detected sperm in 29% of the cohort.
STAR combines high-speed imaging, real-time AI analysis and microfluidic technology. The system takes about two million images, assesses them and isolates sperm it identifies into a small volume. Researchers said recovered sperm have been used for intracytoplasmic sperm injection (ICSI) or cryopreservation, and that the work has so far been associated with at least three live births.
A Possible Alternative to Repeat Searches
Azoospermia means sperm are not found in a semen sample under examination, but extremely low numbers can make detection difficult. Finding even a small number may matter to people seeking to conceive a biological child, because recovered sperm can sometimes be used for fertility treatment. The reported results point to a possible way to identify sperm before or alongside more invasive procedures.
For couples facing a sperm-negative result, the usual next step may include testicular sperm extraction, or microsurgical testicular sperm extraction. The source report says these procedures can be painful and fail about half the time. STAR could potentially help clinicians locate sperm in some cases, but the meeting results do not show that it can replace surgery or guarantee a successful pregnancy. The three reported live births are encouraging outcomes, not a measure of the likelihood of success for other patients.
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From Manual Examination to STAR
According to the researchers, azoospermia affects about 10% to 15% of infertile men. They also said male factors are a primary or contributing factor in about half of infertility cases. The figures describe the broader fertility context; they do not mean that all men diagnosed with azoospermia have rare sperm that STAR can recover.
Hemant Suryawanshi, PhD, of Columbia University Fertility Center in New York, and colleagues developed STAR to search for ultra-rare sperm. One case previously described in correspondence in The Lancet involved sperm found in the ejaculate of a man who had undergone TESE twice. The couple, who had a 19-year history of infertility, had a live birth in December 2025. Suryawanshi said two other live births occurred in July and October 2026.
“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
Questions About Clinical Use
The reported data do not establish STAR’s overall sensitivity, specificity or performance across different laboratories and patient groups. The sample comparison involved sperm deliberately added to azoospermia samples, while the patient series reports detection rates without, in the source material, a detailed independent confirmation rate for every sperm identified. It is also unclear how often a sperm found by the system can be recovered in usable condition or leads to a pregnancy.
The three live births show that STAR-recovered sperm have been used in successful pregnancies, but researchers did not provide a denominator for all patients treated with STAR or a success rate. The report also does not give detailed outcomes for the remaining patients, or establish whether the tool changes the need for surgical retrieval. Its present reliance on highly trained technicians may limit where it can be used.
Simplifying the Laboratory Process
Suryawanshi said his team is working on a simpler version of STAR, while other research groups are developing similar tools. Wider assessment would need to show how reliably the system identifies and recovers sperm in routine practice, how results compare across centers, and whether its use improves patient outcomes. No timeline for a simpler version or broader clinical availability was provided in the report.
For now, the findings were presented at a professional meeting and should be understood as an early report of laboratory and patient-series results. Patients diagnosed with azoospermia should discuss testing and treatment choices with a fertility specialist; the current information does not show that STAR is available as a standard alternative to existing evaluation or sperm-retrieval procedures.
Key Questions
What is the STAR system?
STAR is an AI-assisted sperm detection and recovery system. Researchers say it uses high-speed imaging, real-time analysis and microfluidics to search a sample and collect sperm it identifies.
How often did STAR detect sperm in the patient group?
Researchers reported at least one sperm in 26% of samples from 175 men whose samples had previously been classified as sperm-negative by manual examination. The result does not mean STAR will find sperm in every person with azoospermia.
Has STAR led to live births?
The research team reported at least three live births involving sperm recovered with STAR and used for ICSI or cryopreservation. The source report does not provide the total number of patients treated or a live-birth rate.
Can STAR replace testicular sperm extraction?
The available report does not establish that STAR can replace testicular sperm extraction or other clinical procedures. Researchers described the system as a detection approach and said it currently requires a highly trained technician.
What is not yet known about the system?
Further information is needed on STAR’s performance in routine clinical use, how often detected sperm can be recovered and used, and the rate of pregnancy or live birth among patients treated. The research team also has not provided a timeline for a simpler version.
Source: medpagetoday.com
