Insight
Doctors report first pregnancy using AI system to detect sperm in men previously considered infertile
A couple who had been trying to conceive for 19 years have become the first to achieve pregnancy using an artificial intelligence system designed to detect sperm in men with azoospermia – a condition where no sperm are visible in semen.
The pregnancy was announced in March 2025 by doctors at Columbia University Fertility Center.
It followed the development of the STAR (Sperm Track and Recovery) system, led by Dr Zev Williams, director of the centre.
Male factors are thought to account for around 40 per cent of infertility cases in the US, with azoospermia responsible for roughly 10 per cent of male infertility.
Until recently, there was little doctors could do beyond recommending donor sperm.
Williams explained that semen samples from men with azoospermia can appear normal, but microscopic analysis shows no visible sperm among other cell debris.
As sperm are the smallest cells in the human body, even highly trained technicians often fail to identify them.
The Columbia team spent five years developing STAR, which combines an AI algorithm trained to detect sperm with a fluidic chip that channels the semen through microscopic tubules.
When the AI detects sperm, that portion of the sample is diverted into a separate channel for collection.
The recovered sperm can then be frozen or used for fertilisation.
Inspired by methods used by astrophysicists to find stars and planets, the STAR system is trained to detect what Williams calls “really, really, really rare sperm.”
He said: “If you can look into a sky that’s filled with billions of stars and try to find a new one, or the birth of a new star, then maybe we can use that same approach to look through billions of cells and try to find that one specific one we are looking for.”
He likened the process to finding “a needle hidden within a thousand haystacks,” and noted that STAR is able to do this within a couple of hours and gently enough to preserve sperm for use in IVF.
What makes STAR distinct, he added, is that it not only detects the presence of sperm, but also isolates them automatically—a step that sets it apart from many other AI diagnostic tools.
The system can scan around eight million images in an hour.
Williams recalled the moment he became convinced of the system’s potential: before discarding semen samples deemed sperm-free by embryologists, they were run through STAR.
In one case, after two days of unsuccessful manual searching, STAR found 44 sperm in one hour.
Rosie, 38, who asked to use a pseudonym to protect her identity, and her husband became the first couple to achieve pregnancy using STAR.
They had spent nearly two decades trying to conceive and had undergone 15 unsuccessful IVF cycles. Their Orthodox Jewish faith, Rosie said, kept them hopeful throughout.
Before using STAR, they had explored multiple options to address her husband’s azoospermia, including surgery and bringing in a specialist from abroad to manually search sperm samples.
They also looked into chemical extraction methods, which posed risks to sperm quality.
Rosie said: “There really was nothing else out there.
“Especially because I am running quite a few years ahead of where we should be [for fertility]. I’m not that old, but in fertility years—egg-wise—I was reaching my end.”
They learned about Williams’ programme through a community group and quickly familiarised themselves with the technology.
She said: “We knew exactly what it was, and knew what they were trying to do.
“If they could get sperm in a more natural way without chemicals and hopefully chose the good ones—if the programme was able to do that, we knew we had a better chance.”
The IVF cycle using STAR did not require any extra testing or procedures and followed the same steps as previous attempts.
Rosie said: “We were keeping our hopes to a minimum after so many disappointments.
“We came in, did what we had to do for the cycle, knowing there was probably a very small chance of anything happening. Why should this be any different from every other time?”
Williams explained that in conventional IVF, sperm typically outnumber eggs by a large margin, but in azoospermia cases, the reverse is true.
To maximise the chances of success, his team used STAR to collect several sperm samples in advance, which were frozen.
On the day of egg retrieval, they processed a fresh semen sample through STAR and used any recovered sperm to fertilise the eggs.
The frozen samples were kept in reserve in case no viable sperm were found in the fresh sample.
Within two hours, Rosie was told her eggs had fertilised successfully.
She said: “After the transfer, it took me two days to believe I was actually pregnant.”
Now four months into her pregnancy, Rosie is receiving standard obstetric care, and doctors say everything is progressing normally.
She said: “I still wake up in the morning and can’t believe if this is true or not.
“And I still don’t believe [I’m pregnant] until I see the scans.”
Williams said that azoospermia is just one fertility challenge where AI could be transformative.
Williams said: “There are things going on that we are blind to right now. But with the introduction of AI, we are being shown what those things are.
“The dream is to develop technologies so that those who are told ‘you have no chance of being able to have a child’ can now go on to have healthy children.”
News
Bridging the metabolic wealth gap: The telehealth platform bypassing insurance to democratise care
As weight-loss treatments remain locked behind prohibitive paywalls, a new direct-pay initiative is cutting costs in half for low-income patients, and it could provide a new blueprint for health equity.
It is one of the most persistent, frustrating paradoxes in modern healthcare: the medical innovations most capable of addressing widespread chronic conditions are overwhelmingly priced out of reach for the populations most vulnerable to them.
Nowhere is this more evident than in the current landscape of metabolic health and weight management.
As state governments and insurance providers increasingly restrict coverage for advanced weight-loss medications due to skyrocketing costs, a stark dividing line has emerged. Clinical need is no longer the primary factor in who receives treatment. Affordability is.
This financial barrier disproportionately impacts women, who not only face high rates of metabolic conditions but also frequently serve as the primary caregivers in their households.
For a single mother managing childcare, grueling work hours, and the relentlessly rising cost of living, personal well-being is often the first casualty of a tight budget.
These patients are forced into a holding pattern, watching their conditions progress year after year while highly effective, life-changing treatments remain separated from them by a paywall.
Now, a telehealth platform called Amble Health is attempting to dismantle that wall by bypassing the traditional insurance apparatus entirely.
A Structural Shift for Access
Today, Amble Health announced the launch of the Amble Cares Program, a national initiative designed to cut the cost of medical weight-loss treatments in half for low-income Americans.
The programme arrives at a critical inflection point.
Today, roughly one in eight U.S. adults have utilized advanced metabolic medications, according to a recent KFF Health Tracking Poll.
This surge in adoption has driven a fundamental shift in preventative care, but the distribution of that care has been deeply uneven.
Through the Amble Cares Program, eligible patients can access comprehensive medical weight-loss programmes, which may include prescription medications if clinically appropriate, at up to 50 per cent below standard rates.
To ensure the discounts reach the intended demographic, eligibility is determined by an independent, third-party verification partner, based on verified financial need.
The programme explicitly prioritises individuals and families with limited disposable income, including parents and guardians whose financial flexibility is tied up in providing for dependents.
Once verified, patients are connected directly to licensed clinicians to begin treatment immediately, stripping away the friction of waiting periods.
“Healthcare should not be a luxury item,” said Joey Stiver, CEO of Amble Health. At Amble, we believe that a patient’s zip code or income shouldn’t dictate their metabolic health outcomes.
“The Amble Cares Program is our direct response to the cost of living crisis, moving beyond talk of ‘affordability’ to actually delivering it to the people the traditional system has left behind.”
The Direct-Pay Trade-Off
However, this rapid, lower-cost access comes with a significant structural trade-off.
To achieve these price reductions and eliminate the administrative delays, denials, and red tape associated with traditional healthcare, Amble Health operates strictly as a direct-pay platform.
This means participants cannot use outside coverage. The programme does not accept Medicaid, Medicare, commercial insurance, or even HSA/FSA funds.
For some patients, being entirely locked out of utilizing their existing health benefits may present a new kind of hurdle.
But for those who have already found themselves abandoned by traditional coverage networks, facing outright denials, unnavigable prior authorisations, or insurmountable deductibles, the direct-pay model offers a predictable, transparent alternative to a broken system.
Ultimately, the Amble Cares Program is making a bold bet: that the most efficient way to deliver equitable healthcare to disenfranchised populations isn’t to fix the traditional insurance system, but to innovate entirely around it.
The Women and Equalities Committee (WEC) has warned against “financial half measures” on women’s health as the government published its response to the report.
Ministers launched the renewed Women’s Health Strategy in April after the committee’s March report concluded it was not convinced that the menstrual and gynaecological needs of young women and girls had been sufficiently prioritised in wider healthcare reforms.
It followed the committee’s 2024 “medical misogyny” report, which found women with painful reproductive health conditions such as endometriosis, adenomyosis and heavy menstrual bleeding were frequently finding their symptoms “normalised” and their “pain dismissed” when seeking help.
In both reports, MPs called on the government to recognise the benefits of increased investment in early diagnosis and treatment of women’s reproductive health conditions and provide additional funding needed to transform the support available to millions of women.
In its response, published on 26 May as a command paper, the Department of Health and Social Care outlined action on reducing gynae waiting times, ensuring procedures are conducted with women’s full consent and adequate pain relief, and improving access to contraception for menstrual healthcare in line with the committee’s recommendations.
It said: “The government agrees with the committee’s overarching findings and recommendations for improving women’s health outcomes and experiences.
“We acknowledge the impact that menstrual health conditions can have on women’s lives, relationships, and participation in education and the workforce.
“We recognise that more needs to be done to support women with menstrual health conditions, particularly around listening to women, improving information and education, and enhancing patient experience.”
However, there was no commitment to increase school nurse provision, no measurable actions and targets on countering online misinformation, no new commitments to end inappropriate censorship of women’s online health content, and no further initiatives on tackling racial discrimination or understanding the menstrual wellbeing needs of young disabled and Deaf women.
The response comes after analysis by The Times suggested the government is allocating 60 per cent more funding to its men’s health strategy than to its renewed strategy for women’s health.
Sarah Owen, chair of the Women and Equalities Committee and Labour MP, said: “WEC’s 2024 ‘medical misogyny’ report warned 18 months ago of women in unnecessary pain and undiagnosed for years and called on the Government to recognise the benefits of increased investment in early diagnosis and treatment.
“Our follow up report this March cautioned girls’ and women’s health are not being sufficiently prioritised in system-wide NHS reforms, while initiatives which have proven to be successful in reducing waiting lists and improving women’s healthcare access, such as women’s health hubs, risked being scaled back or discontinued.
“While it’s welcome to see a focus on tackling ‘medical misogyny’ in April’s renewed Women’s Health Strategy and an emphasis on women’s voices being heard, this must be backed by adequate funding, not financial half measures, particularly when compared to men’s health.
“Significant questions remain following today’s response publication over the adequacy of investment being provided, including for workforce training, menstrual health education in schools, research and additional ring-fenced funding for women’s health hubs to deliver services within the emerging neighbourhood health framework.
“There are both opportunities and risks when it comes to increasing use of technology in women’s healthcare.
“As the Committee’s report set out, social media companies should be held to account for inappropriate and disgraceful ‘shadow banning’ censorship of important women’s health content and there should be a rigorous approach to tackling the risks from ineffective, unsafe and exploitative for-profit FemTech apps.
“The Government should take the problem of ‘shadow banning’ more seriously.
“A strategy which does not fully address the concerns set out in WEC’s report, alongside measurable actions and timescales, will only scratch the surface of the issues facing women’s health.
“WEC will keep a close eye on progress and continue to push for long overdue tangible change for women and girls.”
An early PET scan after one cycle of chemotherapy may help predict how aggressive breast cancer responds to treatment, a study suggests.
Research led by The Institute of Cancer Research, London and King’s College London suggests that an early scan taken after one cycle of chemotherapy could help predict how well a patient’s cancer will respond to treatment.
The study focused on patients with triple-negative breast cancer (TNBC), an aggressive form of the disease in which cancer cells lack receptors for the hormones oestrogen and progesterone, as well as the HER2 protein.
Patients with TNBC are usually treated with chemotherapy prior to surgery. While many respond well, residual disease at surgery, typically around six months later, is associated with a significantly poorer prognosis. Identifying people sooner who are unlikely to respond remains a major clinical challenge.
The research explored whether using PET imaging shortly after treatment begins, rather than relying only on MRI scans later in the treatment process, could provide earlier insight into how a patient’s cancer is responding. Twenty-two patients were recruited, with fourteen undergoing FDG-PET scans before treatment and after the first cycle of chemotherapy.
The findings, published in Clinical Cancer Research, showed that changes seen on PET scans after just one cycle of chemotherapy were strongly associated with subsequent response, including whether there was no detectable cancer, known as a complete response, by the end of treatment. Importantly, early PET response showed stronger associations with treatment outcomes than standard mid-treatment MRI scans in this study.
Being able to identify patients who are not responding well at an early stage could allow clinicians to adjust treatment sooner or consider alternative approaches. These findings may also support future strategies to better tailor treatment intensity to individual patients.
The study also compared two types of PET tracers, FDG and FLT, to determine which was most suitable. While both met the study’s technical criteria, FDG-PET was selected for further evaluation due to its better image quality, greater consistency and wider use in clinical practice.
The research also explored how imaging changes after just one cycle of chemotherapy relate to the body’s immune response to treatment. Biopsies taken before and after the first cycle of chemotherapy showed that an increase in immune cells within the tumour was strongly associated with both early PET changes and improved treatment outcomes.
The researchers emphasise that these findings now need to be validated in larger studies. Future work will aim to confirm these results in broader patient groups and explore more accessible imaging approaches, such as ultrasound, alongside PET and MRI.
Sheeba Irshad, professor of cancer immunology at King’s College London and lead of the Breast Cancer Now KCL Research Unit, said:
“In patients who had PET scans both before treatment and after the first cycle, we found that this early scan could predict whether they were likely to achieve a complete response by the end of treatment. These findings highlight the potential of early imaging to guide treatment decisions, and now need to be validated in larger, modern clinical trials.”
Andrew Tutt, professor of breast oncology at The Institute of Cancer Research, London, said:
“Research that helps us determine early who is already benefitting from standard neoadjuvant chemotherapy and who might benefit from clinical trials to find better treatments is vital. This study shows that FDG-PET may have great value in this regard. We hope to be able to design studies that further investigate and validate these findings.”
The study was supported by funding from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust, Breast Cancer Now, Cancer Research UK, and Guy’s and St Thomas’ Charity.
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