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.”
Insight
Women with birth trauma face 2.5x higher healthcare costs – study

Women with childbirth-related PTSD had healthcare costs 2.5 times higher than women without PTSD from six to 12 months after birth, a report found.
The analysis estimated that early prevention of traumatic births and childbirth-related post-traumatic stress disorder (PTSD) could save the NHS around £26m each year.
Women with PTSD were also less likely to have returned to work by 12 months after giving birth, suggesting potential longer-term employment and economic effects.
The report from City St George’s, University of London was launched at an All-Party Parliamentary Group (APPG) on Birth Trauma event on 10 September 2026.
Researchers calculated the potential NHS savings using the number of births reported in NHS hospitals in 2024-25 and the UK prevalence of childbirth-related PTSD.
Around one in 20 women in the UK develop PTSD following childbirth, while recent research has shown that the condition remains underdiagnosed.
The findings draw on research that tracked more than 2,000 women in England and Scotland from pregnancy to two years after birth. Researchers assessed mental health, use of health services and employment outcomes.
The research included assessments of childbirth-related PTSD and PTSD arising from other traumatic experiences. It also included a separate Birth Trauma Association survey examining women’s experiences of birth trauma.
Between six and 12 months after birth, healthcare and support service costs for women with childbirth-related PTSD were 2.5 times those of women without PTSD.
Women with low or moderate symptoms, including those reporting one or two PTSD symptoms, also had higher healthcare service costs than women without PTSD.
Just over half, 53 per cent, of women with PTSD had returned to work by 12 months after giving birth, compared with 68 per cent of women without symptoms.
Women with PTSD were more likely to be referred for mental health support, but more than half received no referral.
Those whose PTSD followed a traumatic birth also had slightly higher healthcare costs than women whose PTSD resulted from other traumatic experiences.
The researchers called for routine PTSD assessment and treatment during pregnancy and after childbirth, alongside greater access to specialist perinatal mental health services.
They also recommended training healthcare staff in perinatal trauma, trauma-informed care and identifying women at risk of PTSD.
The report said further research was needed to establish whether screening, treatments and trauma-informed care pathways are effective and evidence based.
The work follows the APPG’s 2024 Birth Trauma Inquiry, which highlighted the effects of birth trauma on women and families and called for evidence on its wider public health and societal costs.
The report focused primarily on healthcare use and did not attempt to calculate all costs associated with birth trauma and postnatal PTSD, including wider employment, family and societal effects.
Insight
UK reviews surrogacy firm over rejected insurance claims

The UK government is reviewing a surrogacy firm after complaints that medical insurance claims involving surrogates in Mexico were rejected.
The Department of Health and Social Care (DHSC) is considering whether UK-based provider My Surrogacy Journey should remain listed on gov.uk as one of four domestic surrogacy agencies available to intended parents.
The review follows allegations concerning its Mexican sister company, where surrogates are based.
Health minister Diana Johnson said: “The department is looking into the allegations about My Surrogacy Journey.
“As part of that assessment, the department will consider whether it is appropriate for that company to remain on the gov.uk list of agencies.”
Emails sent by My Surrogacy Journey chief executive Michael Johnson-Ellis and seen by the Guardian suggest multiple surrogate women in Mexico had their insurance claims rejected.
The emails also suggest 300 couples using the company were moved to a new insurance provider because of the increased risk of claims being rejected.
Commercial surrogacy is banned in the UK, where only altruistic arrangements are permitted.
My Surrogacy Journey operates a not-for-profit UK branch alongside for-profit sister companies in Mexico and the US. All three companies have the same owners and chief executives.
The reported insurance issues relate to surrogacy arrangements in Mexico.
One couple told the Guardian they paid tens of thousands of pounds to cover medical costs after their surrogate had a hysterectomy during childbirth and an insurance claim was refused.
The Guardian said it understood that at least five sets of parents said they had to cover medical costs after insurance claims were rejected.
In an email to the couple whose surrogate underwent a hysterectomy, Johnson-Ellis wrote: “We have already told you that the insurance companies have been declining some of the claims and we are actively working with the broker to get this issue resolved but you should also consider that they may not be paid out and there is nothing we are able to do to change this …
“We appreciate this is not an insignificant sum but this genuinely is out of our control.”
Johnson-Ellis also said the company had switched insurance providers, writing: “We’re also managing this for 300 other journeys, which is a complex position to be in.”
Lawyers acting for My Surrogacy Journey said the company did not comment on individual cases, but that existing insurance policies were in place and claims continued to be accepted and processed.
They said the company understood that a small number of claims had been rejected and was supporting people seeking to resolve those claims with an insurer.
Under the surrogacy arrangements, intended parents are understood to be contractually required to cover medical costs not paid by an insurer.
The couple said they had been recommended the company’s Mexico option. Its website advertises that intended parents using the route can have a baby in “under 18 months”.
They said they were told the UK route could take up to five years and that the US option was much more expensive.
Lawyers for My Surrogacy Journey said prospective parents are given information about typical timelines, costs, legal frameworks and practical considerations, and that the 18-month timeframe is indicative only.
The couple said their surrogate developed placenta accreta, a serious condition in which the placenta attaches to the wall of the uterus.
Emails from Johnson-Ellis acknowledged that the insurance provider investigated the birth after the surrogate experienced health complications.
The parents are considering legal action, while the Guardian said it understood at least four other couples were reviewing their options.
Phil Brickell, MP for Bolton West, raised concerns in parliament about a separate couple who had used My Surrogacy Journey.
He said: “Two of my constituents recently travelled to Mexico, where their children were born by surrogacy.
“Those births were facilitated by a company called My Surrogacy Journey, which is listed on gov.uk.
“While in Mexico, they had repeated traumatic experiences with the company relating to issues including insurance for their children, accusations of bullying towards staff and repeated efforts to silence any constructive criticism.
“I understand that other members of this house have received similar complaints.”
Brickell called for My Surrogacy Journey to be removed from gov.uk pending a review by the Human Fertilisation and Embryology Authority.
Lawyers acting for My Surrogacy Journey said the company was communicating with DHSC and was confident any issues could be resolved.
Insight
Research uncovers potential new target for breast cancer therapy

Targeting CD1d altered immune cells slowed tumour growth and improved immunotherapy responses in mouse models of breast cancer, researchers found.
The findings suggest blocking the molecule could make the environment around breast tumours more favourable to anti-cancer immune responses.
Further work is needed to understand how these immune changes occur and how the approach could be safely used in patients.
Researchers from King’s College London, the Francis Crick Institute and University College London investigated how immune cells inside breast tumours influence cancer growth.
They focused on myeloid cells, a group of immune cells found in large numbers within tumours that can either support an immune attack against cancer or contribute to tumour growth and immune evasion.
The team examined CD1d, a molecule found on the surface of myeloid and other immune and tissue cells that helps regulate immune responses.
When CD1d was genetically removed from cells in a mouse model of breast cancer, the mice were more resistant to tumour growth. Researchers also saw changes in myeloid cell populations, including increased activity among cells that can help attack cancer.
The team then blocked CD1d using an antibody and again observed changes in myeloid cells and slower tumour growth. Blocking CD1d also improved responses to immunotherapy in the mouse model.
Researchers used single-cell RNA sequencing, a technique that examines gene activity in individual cells, to investigate the immune changes in more detail.
They identified a population of myeloid cells called monocytes that expressed genes associated with inflammation, an important part of the immune response. These cells were particularly important in restricting tumour growth in the mouse models.
A similar pattern of gene activity was identified in data from human breast cancer tumours. Its presence in myeloid cells was associated with positive responses to immunotherapy in breast cancer patients.
However, the findings in people were based on gene expression data and did not test CD1d-targeting treatment in patients.
Professor Patricia Barral, professor of immunobiology at King’s College London and senior author of the study, said: “Many breast cancers do not respond well to current immunotherapies.
“Our findings reveal a previously unrecognised mechanism by which immune cells within tumours are regulated.
“While CD1d is best known for helping immune cells recognise lipid molecules, we found that it also plays a role in shaping the behaviour of myeloid cells within tumours.
“These findings suggest that targeting the immune cells that surround and support tumours could boost anti-cancer immunity and potentially improve treatment responses in the future.”
Researchers now plan to investigate how the immune changes occur and how they can be safely harnessed in patients.
They also want to examine whether targeting CD1d could enhance existing treatments and influence treatment responses in different cancer types.
The work was supported by UKRI BBSRC, Breast Cancer Now and the Cancer Research UK City of London Centre.
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