Smartphone App Helps Diagnose Male Infertility

Bridget M. Kuehn

March 22, 2017

An easy-to-use smartphone-based app could help diagnose male fertility at home, according to a study published today in Science Translational Medicine.

Infertility affects roughly 45 million couples worldwide, and male infertility contributes to more than 40% of those cases. However, men can be uncomfortable with seeking fertility testing in the clinical setting, explained Hadi Shafiee, PhD, the senior author of the study and assistant professor of medicine at Brigham and Women's Hospital in Boston, Massachusetts. Moreover, clinical testing of semen samples can be expensive, time-consuming, and subjective. These barriers, as well as cultural or social stigma associated with infertility, may prevent many men, especially those in resource-poor settings, from undergoing testing at all.

"We wanted to come up with a solution to make male infertility testing as simple and affordable as home pregnancy tests," said Dr Shafiee in a press release. "This test is low-cost, quantitative, highly accurate and can analyze a video of an undiluted, unwashed semen sample in less than five seconds."

To do this, Dr Shafiee and colleagues developed a mobile phone app that uses the phone's camera and an inexpensive microfluidic device to measure sperm concentration and motility, along with a device to position and illuminate the sperm-containing sample. The total materials cost for the device was less than $5.

The researchers tested the device on 350 semen specimens from a fertility clinic and compared the results to those of traditional laboratory-based semen testing. They found that according to World Health Organization guidelines for assessing semen quality, the device was about 98% accurate. They also showed that the device performed well with both trained and untrained users.

The study was thoughtful and well carried out, said Michael L. Eisenberg, MD, director of male reproductive medicine and surgery at Stanford University School of Medicine in California.

The app is one of a growing number of devices in development that aim to provide at-home fertility testing for men, Dr Eisenberg told Medscape Medical News. He noted that many at-home fertility tests and ovulation tracking devices are available for women, but men "are largely ignored." In fact,  about 20% to 25% of the time, US men who are in a couple experiencing infertility are never evaluated, he said. But at-home testing could help boost the number of men who are assessed.

"It lowers the barriers," Dr Eisenberg said.

While he didn't think such tests would replace traditional fertility care, Dr Eisenberg said the tests might act as a preliminary male fertility screen to alert couples of a problem early on and allow them to seek help. They might also allow men to longitudinally track their semen quality. He noted that some other apps in development provide men with assessments of habits that can affect fertility and recommend changes.

"There are a lot of things men do that can impact fertility," Dr Eisenberg said. "As men work to improve their health, they can improve semen quality over time."

The authors also suggest that the device could help make male infertility testing accessible and affordable in resource-poor settings and eliminate the need for expensive laboratory testing.

It might also be useful for home monitoring of sperm levels after vasectomy. Currently, such follow-up testing is recommended to ensure the success of the procedure, but many man don't follow through on the testing, Dr Shafiee and colleagues write.

Dr Eisenberg cautioned that if the test is used to track semen after vasectomy, it should be made clear that men are looking to have nonmoving sperm, not just a sperm count below a particular threshold.

Although the app tested by Dr Shafiee and colleagues is still in an early phase of development, Dr Eisenberg noted other products closer to becoming available. In the long term, he said, the growing availability of male fertility tests would help to raise awareness among the public and physicians, just as the growing availability of medications to treat erectile dysfunction has boosted awareness about the condition and its treatment.

"A lot more people will learn there are options and things you can do about it," he said.

Dr Hadi Shafiee and Brigham and Women's Hospital hold a patent on their home semen evaluation technology. The other authors have disclosed no relevant financial relationships. Dr Eisenberg has served as an advisor for several companies with reproductive products: Sandstone Diagnostics, Glow, Embraceher, and Reprovantage.

Sci Transl Med. Published online March 22, 2017. Abstract

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