Finding viable sperm in infertile men can take days. AI did it in hours.

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After 18 years of infertility, a couple could finally have a baby thanks to artificial intelligence.

The father had a rare condition that left him with almost no detectable sperm. Then fertility specialists found a novel path to the mother’s pregnancy. A tiny camera captured millions of images in a semen sample. AI scoured them for viable sperm in hours – a process that might have otherwise taken days. The result was a speedy extraction of the sperm that could at last fertilize an egg.

Researchers at the Columbia University Fertility Center say this procedure, conducted in March, amounts to the first-known use of AI-enabled conception using this particular technology.

While AI has long been used in other ways to assist couples who want a baby, including assessing embryo viability, Columbia’s work shows how the technology can offer a chance at biological parenthood for those experiencing severe male infertility.

How does it work?

Normally, in-vitro fertilization involves taking sperm from a semen sample and fertilizing an egg. But for men with azoospermia, which causes extremely low sperm counts, the sperm is difficult to find and can be damaged through existing methods of searching for viable cells.

Zev Williams, director of Columbia’s fertility program, said that identifying viable cells can take hours or days of searching under a microscope and often results in no usable sperm.

“Labs searched for two days and found nothing,” said Williams. “We ran the same sample and found 44 sperm within an hour. That changes everything for a couple who thought they had no path forward.”

The process starts with a semen sample loaded onto a small, single-use chip designed to move fluid through a controlled channel. As the sample flows, it is illuminated and imaged by a microscope linked to a high-speed camera. The system captures millions of individual frames. Artificial intelligence then analyzes these images in real time, scanning for the presence of sperm and then, within milliseconds, isolating that sperm.

Once isolated, the sperm can be frozen for future use or used in IVF through intracytoplasmic sperm injection, a procedure in which a single sperm is injected directly into an egg. In many cases, only two or three sperm are found in the entire sample, making preservation important.

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Robert Brannigan, president-elect of the American Society for Reproductive Medicine, said this technology seems promising for those with azoospermia, which affects 10 to 15 percent of infertile men.

“Even the discovery of a single viable sperm can be life-changing,” said Brannigan, a urologist at Northwestern University who was not involved with this treatment.

“I see it more as a tool,” said Brannigan. “It enhances the work of laboratory technicians, especially in cases that are like searching for a needle in a haystack.”

Other options for men with low sperm

For men with azoospermia, other options for IVF are available but have traditionally been limited. Embryologists can spend hours manually scanning a semen sample in hopes of spotting a viable sperm cell. In other cases, surgeons perform procedures to search for sperm directly from the testicles.

These surgeries can be painful, carry risks and are not always successful. Some lab techniques use stains, dyes or lasers to help identify cells, but these substances can be toxic to sperm and make them unusable for fertilization.

“This could help some men avoid surgery altogether,” said Allison K. Rodgers, a reproductive endocrinologist at the Fertility Centers of Illinois who was not involved with the recent AI case. “I was pleasantly shocked by the findings. We assume that with our current lab techniques, if sperm are present, we’ll find them, but in this [Columbia] case, embryologists searched for 48 hours and found nothing.”

Rodgers said the system challenges assumptions about the limits of current laboratory methods.

“It’s amazing and makes me realize that maybe what we thought was advanced still has a long way to go,” she said. “I think AI is going to absolutely revolutionize IVF. The future of reproductive medicine is going to look a lot like this.”

Why there’s skepticism

Brannigan said more testing is needed at other clinics to make sure the results hold up. He also said doctors should carefully track how well the procedure helps people get pregnant.

“At face value, this looks promising, but as with any new technology in medicine, especially in reproductive care, we need to follow the data and study it further,” Brannigan said.

Gianpiero Palermo, a male infertility specialist at Weill Cornell Medicine and the physician who pioneered the method to inject a sperm directly into an egg, said he is not convinced the technology marks a significant breakthrough.

“You are attracting patients who have been told they have no sperm and offering what may turn out to be false hope,” Palermo said.

Williams, the director of Columbia’s fertility program, said the tool should not be used to give false hope, but it’s an avenue to increase the chance of success.

“If sperm are present, this method can find them,” said Williams. “Instead of relying on a microscope and declaring a sample empty, this approach gives us a way to counsel men realistically before undergoing a microTESE procedure. If sperm exist, there’s now a good chance we can identify them.”

Williams said the team plans to explore how the technology could be adapted to help patients with other forms of infertility, such as searching for the healthiest sperm in a sample, and trying to help assess egg and embryo health in cases of female infertility.

“This opens the door for people who had no chance,” Williams said. “It is one of those moments in medicine where you realize you are seeing something that was always there but could never be found.”

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