9 min read
After years of struggling to conceive, Reece and Annabelle may finally have an answer
As artificial intelligence transforms almost every aspect of our world, researchers hope it will also help millions living with infertility. Read the second in our three-part series on the Future of Fertility.
Published 10 March 2024 6:35am
Updated 10 March 2024 5:13pm
By Sarah Conte, Caroline Riches
Source: SBS News
Image: Annabelle Grace and Reece Conca have been trying to conceive for nearly four years. (Supplied)
When former AFL player Reece Conca met his partner Annabelle Grace, the couple wasted no time in trying to start a family.
"I've always wanted to be a father, I absolutely love kids," the 31-year-old told SBS News.
But when , the Melbourne-based couple sought help, which led to a devastating diagnosis: Conca has azoospermia, a rare condition affecting around one in 100 men that means there's no sperm in the semen.
"It's shocking news, especially for a male," Conca said.
"Emotionally I really struggled with that at first … feeling really ashamed and embarrassed. And then, later on down the track there was a real sense of guilt … I was the one that was hindering Belle from being able to have kids."
Conca encourages men going through similar experiences to process their feelings and seek support, both from medical professionals and in their own networks.
"The more people you've got in your corner, the easier it makes the journey. I think especially for males, it's just realising that you are not alone in your struggles."
Many people don't realise that infertility is just as common in men as it is in women.
It's an invasive process. Over the six months before the procedure, Conca has had to self-inject hormones each night and undergo regular sperm analysis and blood tests.
After the second procedure, there was good news.
"I remember waking up post-surgery and a specialist came in and he'd drawn this picture of a sperm saying we found some, which was lovely, and we had a bit of a laugh," Conca said. “And after he left I kind of broke down."
Enter the AI assistant
There is hope artificial intelligence can dramatically improve the chances of fatherhood for men like Conca.
Sydney-based start-up NeoGenix Biosciences has developed an AI assistant which, after analysing thousands of sperm images, can help a surgeon detect sperm quickly and accurately.
It can then direct the specialist to the most likely part of the tissue to find them.
NeoGenix CEO Steven Vasilescu said detecting super rare sperm without AI was "like finding one star in a constellation".
"It can take three to six hours to find a single sperm," he said.
Currently in the study phase, a clinical trial is planned later this year, which is attracting interest from clinics worldwide.
There are already promising signs.
"What we're seeing is a dramatic drop in the time it takes to perform these procedures, and AI is helping find more sperm than an embryologist without AI," Vasilescu told SBS News.
He emphasised that AI would not replace human expertise; the bot would simply enable the embryologist to work more efficiently — and quickly.
"Sperm isn't meant to be outside the body for very long, so time really is of the essence. So the quicker we can make these processes and find these sperm that are slowly dying in these dishes, the better," he said.
Reece Conca (left) has azoospermia, a rare condition that means there's no sperm in his semen. He says has felt guilty that he is hindering his partner Annabelle (right) from being able to conceive. Source: Supplied
"In Reece's case, there was a chance we wouldn't find sperm at all," Cattrall said.
"For couples with infertility, we know that the stress that they feel with the diagnosis can be as severe as being diagnosed with cancer.
“And so anything that we can do in terms of medicine and the technology to speed up the time to pregnancy reduces the emotional burden."
Using AI knowledge in the procedure brings exciting possibilities, she said.
Other ways AI is helping those with infertility
Sperm selection isn't the only way AI is transforming infertility treatments.
In the 1990s, Professor David Gardner, now the scientific director of Melbourne IVF, developed the embryo grading system used today after a defining moment the decade before.
"When I performed my first IVF cycle, I went to check the patient's name band as we went into theatre to do the egg retrieval," Gardner said.
"She was crying and she just looked me in the eye and said 'please, please get me pregnant'.
"That changed my life forever."
In the 1990s, embryologists would examine one image; now the embryo's development is filmed as a time-lapse, with AI used to analyse thousands of images, all the while being taught which ones lead to a pregnancy and which ones don’t.
The AI tool developed by NeoGenix Biosciences CEO Steven Vasilescu and IVF Australia embryologist Dale Goss can instantly identify sperm in tissue samples. Source: Supplied.
Gardner said AI was helping to reduce time to pregnancy at no extra cost to patients. One IVF cycle can cost around $6,000 out of pocket, though some low-cost and government-funded clinics are sprouting up across the country.
"We're making the right decision over which embryo to transfer first, more often," he said.
One day AI could also be used in preimplantation screening, a procedure to identify embryos that develop differently, suggesting genetic abnormalities," he said.
If this happens, the patient may undergo counselling and be recommended to have a genetic screening test.
"We're using AI to help identify individuals at risk. So, in fact, it's actually saving a lot of heartache in the long run," Gardner said.
She was crying and she just looked me in the eye and said 'please, please get me pregnant'.Professor David Gardner, fertility specialist
Meanwhile, Professor Beverley Vollenhoven, reproductive endocrinologist, infertility specialist and head of gynaecology at Monash Health in Victoria, is investigating whether AI could help personalise fertility medicine, by analysing human genes.
Vollenhoven hopes to use whole genome sequencing to work out how genes affect a woman's reaction to medicine in order to personalise her fertility treatment.
"If we had to go through someone's whole genomic sequence, it would take a very long time … (AI) brings us speed and accuracy," she told SBS News.
The approach will be especially helpful for those who struggle to conceive, such as women with low ovarian reserve or older women, who suffer from a lower quantity or quality of eggs.
LISTEN TO
Could artificial intelligence bring new hope to couples facing infertility?
SBS News
09/03/202406:36
Tricky ethical questions
But grading sperm and embryos is a subjective process with the possibility of bias.
And what if AI analysis detects more than we bargained for? Genome sequencing could reveal that a patient has a high risk of cancer, for example.
Vollenhoven said medical experts would be obliged to inform the patient of the results, which she admitted could be "distressing".
All patients having genetic testing of any sort must undergo counselling both beforehand and afterwards, she said.
When it comes to assessing sperm quality, Vasilescu said the key was ensuring the AI model was "robust".
"What we do need to be careful of is how much data we provide and making sure we get a really good breadth of data,” he said.
AI is helping specialists to find sperm in the testes of men with fertility issues. It can also help grade the quality of sperm. Source: Getty / Ed Reschke
"We grade our embryos using conventional means, and then we use artificial intelligence to say, 'what do you think?' We don't turn to AI and say, 'tell us what to do'. We turn to AI and say, 'can you help us make these decisions?'"
Who monitors the robots?
The Therapeutic Goods Administration (TGA) and the Australian Commission on Safety and Quality in Health Care (ACSQHC) are closely monitoring developments in AI.
While acknowledging how the technology is improving patient outcomes, they also caution vigilance.
"Health service organisations will need to evolve their governance around the use of AI to meet both the opportunities and risks for medicine and health care," a ACSQHC spokesperson said.
"We are particularly focused on the safe implementation of AI in acute care settings and ensuring that patients receive safe and ethical care."
A TGA spokesperson has warned Australians against using AI technology used overseas for medical purposes that it hasn't approved.
"It is advisable they search for products that have received approval from a comparable overseas regulator," the spokesperson said.
"Users should seek sufficient information to understand how the AI has been trained, including any biases, and be provided with information regarding how their personal data is being used."
The future of fatherhood for men like Reece Conca
Conca hopes these innovations will make the dream of parenthood a reality for more people such as him and 30-year-old Annabelle.
"I'm definitely pro-AI and all the positive impact it can have in the future, especially in this space around fertility," he said.
“And the more advancements we can make in this field, the more it's going to be able to help couples conceive.
"If AI can help in terms of cutting down the amount of treatment … and the finances that you have to fork out, I think that would be really, really important for a lot of people."
This article was produced in collaboration with the Australian Science Media Centre and supported by a META Public Interest Journalism Fund administered by the Walkley Foundation.
