The good thing about trying to get pregnant is that there are a lot of options. For women, a plethora of apps help you monitor your fertility, by sampling bodily fluids to measure hormones or pinpointing where you are in your menstrual cycle. And yet there’s a major factor that’s often overlooked when a couple is struggling to conceive: the man.
One in 10 American men struggle with some kind of infertility issue—yet relatively few fertility devices exist for them. "Although men contribute to infertility in 40 to 60 percent of cases, it's mostly women who carry the weight of infertility," says Hadi Shafiee, a medical engineering researcher at Harvard Medical School. "And when men [do] go through the process, they have an … awkward experience."
Shafiee is referring to the main way doctors measure a man’s fertility: by having him ejaculate into a cup in a clinical setting.
Lowell Ku, an obstetrician-gynecologist in Dallas who specializes in infertility issues, knows this process all too well. He and his wife now have two children, but they struggled with infertility issues for years. “This nurse gave me a cup and escorted me to a room … and I have to focus on what I’m doing and collect this sample,” Ku recalls. “And then I’m very embarrassed, and then I walk out of the bathroom and hand it over to this person. It’s very awkward.”
Now, Shafiee has helped create a new device that aims to alleviate some of the discomfort that Ku and millions of men who struggle with infertility go through. The device could easily be attached to a smartphone and used in the comfort of one’s own home—thus equipping men with an affordable, portable way to measure their own sperm count. The hope is that it could help shift some of the fertility burden away from women, as well as aid family planning in developing countries.
According to a description of the device published yesterday in the journal Science Translational Medicine, men would put a small sample of semen onto a disposable slide and insert the slide into the device. The device would then use the smartphone's camera to record the sperm in motion on the slide, calculating their movement, or motility, as well as their concentration. A small scale would also calculate the overall sample size weight, which could be plugged into an algorithm to help determine the semen quality.
The app was about 98 percent accurate in hundreds of tests of semen conducted by the researchers, according to the study, even when tested with untrained users of the app.
Even better, the components of the device cost less than $5 altogether. That price tag makes it a fairly affordable option for most Americans, and an attractive option for smaller clinics and hospitals that might not be able to afford the standard CASA sperm analyzers that can cost tens of thousands of dollars, Shafiee says. These clinics are forced to do manual semen analysis, a process that can be highly inaccurate, he adds.
Shafiee also envisions that such a device could be used in clinics catering to men struggling with infertility issues in lower-income countries. "If you have such a situation here, then imagine what is happening in developing countries," he says.
Fred Licciardi, a founder of New York University’s fertility center who also sits on the board of Baby Quest, a California-based organization seeking to help lower-income couples afford fertility treatments, agrees that the new device could benefit many American clinics. “It's actually a pain to do this test,” says Licciardi, who was not involved in developing the new device. “It's really a test that I believe many clinics would love to load off.”
Another potential use Shafiee sees is for men to track their own fertility—or lack thereof—after a vasectomy. Roughly 0.15 percent of vasectomies fail, meaning a man can occasionally be fertile following a vasectomy and not know it. For this reason, men are supposed to go to a clinic for two semen tests in the 6 months following their operation—but many never bother to make these appointments, Shafiee says. This device could provide them with an easier option.
The app could not only make sperm testing more affordable and accessible, but also more comfortable, says Matthew Wosnitzer, a Connecticut urologist who specializes in male infertility. "There is inherent anxiety associated with producing specimen for semen analysis in a medical facility," says Wosnitzer, who was not involved in developing this device. "Men may use home testing to follow semen quality in a confidential straightforward and convenient manner."
Shafiee says this could also help men who may be prohibited by their cultural or religious norms from engaging in masturbation in a clinic. "Something like this device can be very instrumental to help the couple provide the sample at home with their partner,” Shafiee says.
Ku agrees that “to do this sort of analysis at home with a low-cost, convenient device” would be a vast improvement. However, he points out that it wouldn’t be a full replacement for a clinical sperm test. That’s because the device only measures two factors that affect a man’s possible fertility: sperm count and motility. There are many other factors that only a professional examination can currently reveal—such as shape and the presence of red or white blood cells or foreign debris, Ku says.
For instance, what if a man tests himself and has a good sperm count and motility, but perhaps has another issue with his semen? “I worry that this might actually give the males a false sense of security,” Ku says. “There are still so many other parameters that require human eyeballs.”
Licciardi adds that he would like to see some more “fine-tuning” of the device’s measurements of sperm count and motility. But he’s confident that Shafiee’s team is on the right track with their work. “They are very close,” Licciardi says.
This wouldn't be the first smartphone-based sperm test on the market: the YO Home Sperm Test was approved by the FDA in January. It works by a similar mechanism, using the smartphone camera and an app to record and analyze semen samples. However, unlike YO, Shafiee says his device will calculate semen quality based on already established parameters defined by the World Health Organization and used worldwide. He has filed a patent application for the device and is working to put together an application for FDA approval.
Despite his concerns, Ku says he sees this new device as a “step in the right direction” when it comes to helping men take control of their own fertility. He is particularly attuned to the appeal thanks to his own experiences as an impoverished doctor in training—“we had nothing but debt,” he says [of he and his wife's time in med school]—which led him to get involved with Baby Quest and work to give many discounts at his own clinic. “I think this is a really cool thing,” Ku says.