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Stuck in the 1950s? Why we need to shake things up in male fertility testing



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There has been little innovation in the analysis of male fertility since the 1950s. Why?  Tobias Boecker, Paris-based medtech entrepreneur is co-founder of Nanovare – a system that uses AI to help medical professionals to improve and speed up male fertility analysis – explores the current crisis in this field and what can be done to change things

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Birth rates are dropping, notably in the Western world. Between 1960 and 2015, the birth rate per woman in Germany decreased from 2.4 to 1.5, in the UK from 2.7 to 1.8 and in the US from 3.7 to 1.8. There are many external factors that influence this trend such as the increased age of marriage, the focus on professional careers, or the modernisation of social systems which eliminate parents’ need to have many children to help support them in old age. Another factor that is becoming increasingly important is our own reproductive health, which depends on our lifestyle choices (eg smoking), environmental influences (eg pollution), and medical factors (eg genetic preconditions). Each year, around 90 million couples try to conceive naturally without success. The most common misconception is that the problems primarily stem from women. This opinion is largely founded in men’s tendencies to neglect their own fertility problems rather than in scientific fact. So it’s no wonder that technology companies saw an opportunity to develop products and services to cater for women who are trying to conceive. Prominent examples can be found in the fertility awareness app Kindara, the Glow fertility tracker, or the ovulation tracking bracelet Ava.

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The Ava Bracelet

What about the men?

While this is a positive trend, allowing women to take control of their reproductive health, it fails to address the impact that male fertility problems are having. In fact, sperm concentration in Western men has halved since the 1970s, which is contrary to most other healthcare trends since the advent of modern medicine. People are healthier, living longer, suffering from fewer diseases, yet male fertility has been steadily declining. From a scientific standpoint, the reasons for this decline are still being disputed. So what is being done in the field of male fertility?

Tobias Boeker

While there are several products in the market that allow men to screen their fertility (eg SpermCheck), these products do not offer a complete medical diagnosis. This kind of analysis is currently only being conducted in laboratories of fertility clinics where a qualified professional assesses several parameters including – but not limited to – sperm concentration, motility and morphology. While manual microscopic analysis is the gold standard, this process takes a significant amount of time (between 20 and 60 minutes) alongside extensive training of staff. In addition, regulations in many countries require at least two analyses in order to eliminate the risk of human error. While being accurate, the need for more sophisticated semen analysis and efficient screening has developed. A fully automated computer-assisted/aided sperm analysis, referred to as CASA, is the result. CASA, which dates back to 1985, had the objective to reduce the time and human interaction involved in the process as well as to provide a more accurate and precise semen assessment compared to conventional microscopy. To date, however, the technology lacks true acceptance by the medical community outside of the field of animal reproduction. As concluded in a 2013 study, ‘CASA cannot accurately predict “fertility” that will be obtained with a sperm sample or subject,’ (Amann, RP & Waberski, D; 2013; Computer-assisted sperm analysis (CASA): Capabilities and potential developments).

As long as professionally equipped laboratories aren’t able to fully automate semen diagnostics because of these reasons, it will take years until we will be capable of bringing this technology to people’s homes. So what can we do today to make the male fertility diagnosis and treatment process more efficient and accessible? At Nanovare, we are convinced that the approach needs to be two-fold: first, we need to thoroughly understand the factors influencing male reproductive health. Although some medical professionals can diagnose fertility problems, they lack capability in reliably identifying the reasons for it and determining efficient treatments or even indicating probability of recovery. Second, in order to do so, we need to start at the place where male fertility is being analysed today: the laboratory.

A new approach

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Mojo Pro

With mojo pro, we are developing a new solution for rapid automated semen screening that allows fertility clinics, sperm banks, university clinics, and specialised laboratories to analyse sperm quality much quicker, more precisely, and with a higher cost efficiency than existing medical-grade solutions. Although mojo pro is computer-assisted, it is different from the classical CASA system: it is a smart microscopic solution that becomes even smarter and more precise with use and compares to conventional microscopy, the gold standard of analysis, as opposed to CASA. Not only will mojo pro be able to dramatically improve the way laboratories evaluate male fertility today, it will also provide the ground for using Artificial Intelligence (AI) and Data Science to evaluate a couple’s risk of not being able to conceive naturally, along with targeted and actionable insights for fertility improvements. Only then will it be possible to start thinking about bringing technology to assess male reproductive health into the homes of affected men and couples. Any claims made today to consumers about properly assessing male fertility levels and helping to improve them are nothing more than empty promises that create false hope. MenTech has a long way to go but we believe data is the starting point.

After receiving a first investment by one of the world’s largest VCs in the field of connected devices, SOSV, and spending three months in Shenzhen, China, to develop the hardware, Nanovare is now entering into partnerships with fertility clinics, sperm banks, and specialised laboratories worldwide to pilot mojo pro. The company has equally been granted funding by Horizon 2020 to accelerate the development of its machine-learning platform and is actively looking for research partners who are interested in the new field of data science in male fertility.

About the author

Journalist and editor Kathryn Reilly has worked in consumer, contract and medical writing for more than 20 years.

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