The first pregnancy using an artificial intelligence (AI) procedure has been carried out by doctors at Columbia University Fertility Centre in a couple that had been trying to start a family for nearly 20 years – with the woman now four months pregnant, and with the scientists optimistic that AI might help with other fertility issues as well.
The centre’s director, Dr Zev Williams, told TIME Magazine the pregnancy was possible due to an advance the team developed to address azoospermia, or a lack of detectable sperm in the ejaculate.
Male factors account for about 40% of infertility in America, and azoospermia is responsible for about 10% of those cases. Until recently, there was little doctors could do to address the lack of sperm needed to fertilise an egg, other than using donor sperm.
While a sperm sample from a man with azoospermia might look normal to the naked eye, the microscope tells a different story, Williams says. Highly trained technicians rarely find any sperm in these samples, which are often filled with other debris. Add to that the fact that sperm are the smallest cell in the body – so even the best fertility technicians rarely find sperm in azoospermia samples.
That’s where AI comes in. Williams and his team spent five years developing a system that combined an AI algorithm for detecting sperm with a fluidic chip that passed the semen sample through a tiny tubule on a plastic chip. If the AI picked up sperm, that tiny portion of semen would be directed to a separate tubule and collected.
The few sperm isolated in this way could then be stored, frozen, or used to fertilise an egg.
Called STAR, for Sperm Track and Recovery, the system was inspired by similar approaches that astrophysicists use to enlist AI to detect new stars and planets.
“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 single specific one we are looking for,” said Williams.
In this case, STAR is trained to pick up “really, really, really rare sperm”, he said. “I liken it to finding a needle hidden within a thousand haystacks. But it can do that in a couple of hours – and so gently that the sperm we recover can be used to fertilise an egg.”
STAR is distinct from AI systems that have been developed to scan and detect specific features, Williams says, because it combines that analysis with the ability to also actively isolate the target in question – in this case, any sperm found in a semen sample. The system can scan 8m images in about an hour, and Williams remembers the moment when he was convinced that STAR could become a powerful tool for treating certain forms of infertility.
“To test the system, before we discarded samples where embryologists could not find any sperm, we decided to run those samples through the system. The embryologists really worked hard to find sperm, since they didn’t want to be outshone by a machine. In one of the samples they analysed for two days and found no sperm, STAR found 44 in an hour.”
Rosie and her husband became the first couple to fall pregnant using STAR in March 2025. The couple spent nearly 19 years trying for a baby pregnant, and Rosie – who asked to use a pseudonym to protect her privacy – said their Orthodox Jewish faith kept them hopeful during 15 unsuccessful IVF cycles.
Before the pregnancy, they had explored multiple options to address her husband’s azoospermia, including surgery and enlisting an expert from overseas to manually analyse and isolate sperm from his samples.
They also researched efforts to extract sperm that were more controversial because they involved using chemicals that could potentially be detrimental to the quality of sperm.
“There really was nothing else out there,” said Rosie (38), of their options before learning about STAR. “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 were introduced to Williams and his fertility programme through a community group and learned everything they could about the system.
“If they could get sperm in a more natural way without chemicals and hopefully chose the good ones – if the programme were able to do that, we knew we had a better chance.”
For the couple, using STAR did not require any additional testing or procedures: their successful cycle in March proceeded no differently from any of the other IVF cycles they had experienced.
Usually in an IVF cycle, there are far more sperm than eggs, saids Williams, but in cases of azoospermia, the opposite is true. So to ensure a couple has the best chance of a pregnancy, Williams and his team collect several batches of sperm using STAR and freeze them. Then they coordinate the mother-to-be’s ovulation cycle on IVF, and on the day they retrieve her eggs, they collect a fresh semen sample, run it through STAR, and use any sperm collected to fertilise any available eggs.
The frozen sperm serve as back-up in case no fresh sperm can be found.
Within two hours after collecting her husband’s sperm that March, they learned that Rosie’s eggs had been successfully fertilised and were ready to be transferred to her uterus a few days later.
Now four months along, Rosie is receiving standard obstetric care, and all indications are that her pregnancy is proceeding well. “I still wake up in the morning and … don’t believe I’m pregnant until I see the scans.”
Williams said azoospermia was only one of many infertility issues that AI could address.
“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.”
TIME Magazine article – Doctors Report the First Pregnancy Using a New AI Procedure (Open access)
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Infertility affects one in six worldwide, large-scale WHO analysis finds
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