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Researchers at Columbia University Fertility Center say the AI-powered STAR system detected at least one sperm in 26% of samples from 175 men whose samples had been judged sperm-negative by manual examination. They also report at least three live births involving sperm recovered with the system, but the findings are early and STAR requires a highly trained technician.
An AI-powered system called STAR detected at least one sperm in samples from 26% of 175 men whose samples had been classified as sperm-negative by manual examination, researchers reported at the American Society for Reproductive Medicine annual meeting. The team also said sperm recovered with STAR have been used in cases resulting in at least three live births, though the findings do not establish how often the tool will help patients achieve a pregnancy.
STAR, short for Sperm Tracking and Recovery, combines high-speed imaging, real-time artificial intelligence and microfluidic technology. The system takes and analyzes about two million images, then isolates sperm it identifies into a small volume, according to the researchers led by Hemant Suryawanshi, PhD, of Columbia University Fertility Center.
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 samples and found 167 sperm in total. The clinician found sperm in three samples, detecting four altogether. The researchers described the total as a 41-fold difference in sperm detected in this test; it is not a measure of clinical pregnancy success.
In the separate group of 175 consecutive patients, STAR detected at least five sperm in 22% of samples and at least 10 in 19%. Some men had previously undergone testicular sperm extraction, or TESE, and were still classified as sperm-negative; STAR detected sperm in 29% of that subgroup. Researchers reported that recovered sperm were used for intracytoplasmic sperm injection, or were cryopreserved, in cases associated with at least three live births.
A Possible Alternative to Repeat Surgery
For men diagnosed with azoospermia, finding sperm can affect whether a couple has an option to pursue a biological child using the male partner’s sperm. Researchers say the results suggest that some samples labeled sperm-negative may contain rare sperm that are difficult to find through manual examination. STAR could offer another way to search before or alongside more invasive procedures, if its performance is confirmed and the system becomes practical to use.
When sperm are not found in an ejaculate, clinicians may consider TESE or microsurgical TESE, procedures that retrieve sperm from the testes. The source report says these procedures can be painful and fail about half the time. STAR is not shown here to replace surgery or to work for every patient: the study reports detection results, not a controlled comparison of treatment outcomes. The three reported births are encouraging cases, but they do not establish a general success rate.
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How STAR Was Tested
Azoospermia means that sperm are not detected in a semen sample. The researchers note that in some cases, sperm may be present in such small numbers that manual examination misses them. They estimate that 10% to 15% of infertile men have azoospermia, and say male factors contribute to about half of infertility cases.
The research team tested STAR first with samples containing a known small number of sperm, then evaluated samples from patients referred for analysis. In that patient group, all 175 men had been deemed sperm-negative by manual examination before STAR testing; the median age was 36 years. The report also describes one live birth in a couple with a 19-year history of infertility: STAR found sperm in the man’s ejaculate after he had undergone TESE twice. The child was born in December 2025, and the case was reported as correspondence in The Lancet. Researchers said two other live births occurred in July and October 2026.
“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.”
— Hemant Suryawanshi, PhD, of Columbia University Fertility Center, speaking to MedPage Today
Questions About Access and Accuracy
The report does not establish how STAR performs across a broader range of clinics, whether results are consistent between operators, or how often detecting sperm leads to a pregnancy or live birth. The 26% figure refers to samples in this particular group of 175 referred patients; it should not be treated as a rate for all men with azoospermia. The report also does not provide enough information to compare STAR directly with surgery or other clinical approaches across a controlled patient group.
It remains unclear when the tool might be available more widely, what it would cost, and which patients would be most likely to benefit. The research team says STAR currently requires a highly trained technician. Researchers are working on a simpler version, and other groups are developing similar tools, but no timeline or evidence of routine clinical availability was provided.
Further Testing and Easier Operation
The researchers say they are working to make STAR simpler for technicians to operate. Wider clinical use will depend on further validation, including whether other teams can reproduce the detection results and whether the approach can be integrated into fertility care. The team has not announced a timetable for those steps.
For now, the meeting findings provide evidence that the system can detect sperm missed by manual examination in some samples, alongside a small number of reported births using recovered sperm. Patients and clinicians will need more information on reliability, likely outcomes and access before judging how STAR should fit into individual fertility treatment decisions.
Key Questions
What is STAR?
STAR is a system that uses high-speed imaging, AI and microfluidic technology to detect and isolate sperm in a sample, according to its developers.
How often did STAR find sperm in the patient group?
Researchers reported at least one sperm in 26% of samples from 175 men whose samples had been judged sperm-negative by manual examination. That result applies to the study group, not necessarily to all men with azoospermia.
Does STAR mean a man diagnosed with azoospermia can have a biological child?
The findings do not guarantee that. Researchers reported at least three live births involving sperm recovered with STAR, but the report does not establish a general pregnancy or live-birth success rate.
Can STAR replace testicular sperm extraction?
The study does not show that STAR replaces TESE or microsurgical TESE. Researchers presented it as a way to detect rare sperm; more evidence is needed to define how it should be used in clinical care.
Is STAR widely available?
The report gives no information on broad availability or cost. The system currently requires a highly trained technician, and its developers say they are working on a simpler version.
Source: medpagetoday.com
