This podcast was produced in collaboration with the Australian Science Media Centre and supported by a META Public Interest Journalism Fund administered by the Walkley Foundation.
TRANSCRIPT
Having made his mark in the AFL, the next goal for Reece Conca and his partner Annabelle, is to start a family.
"I've always wanted to be a father, absolutely love kids have for a really long time. We just tried naturally. We tried for I think 10 to 12 months and then put everything in place after that once we realized it wasn't necessarily happening."
Around one in 20 men has a low sperm count that leads to infertility.
One in a hundred, like Reece, has azoospermia, where they have no sperm count at all.
"I think it's kind of shocking news, especially for a male. It's not something you ever really expect. I didn't know anything about male infertility, didn't even really know it existed. I think like a lot of society, I just kind of assumed that most of IVF struggles were female related. There's a lot of guilt attached to it, a lot of anger, this real sense that it's unfair and they're all valid emotions. And for men, the very easy option is just to bottle it all up and soldier on."
Doctor Fleur Cattral is Reece's doctor, and the medical director at Melbourne IVF.
"For couples that are faced with infertility, we know that the stress that they feel with the diagnosis of infertility can be as severe as being diagnosed with cancer. It's a real hidden grief in our community that people don't discuss because often they're embarrassed about it and so they can't disclose it to family and friends.”
Hoping for a breakthrough, Reece has had two surgeries called microteses, where tissue samples are taken from the testes so specialists can search for rare sperm.
This is just one area where experts hope artificial intelligence can improve outcomes for patients.
Steven Vasilescu is the CEO of start-up NeoGenix biosciences, which has been working on a new AI tool with IVF Australia.
"What ends up happening there is once we've retrieved the tissue from the testes, we have to find these super rare sperm. It's like finding one star in a constellation of cells that aren't what you're looking for. So while we're looking for that, that can take three to six hours to find a single sperm. We've trained this model to identify just sperm in complex, very, very messy tissue samples. And we've done that through training it, providing it with hundreds or thousands and thousands actually of images that we've identified as sperm through various staining processes. Sperm aren'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, slowly dying in these dishes, the better we can make outcomes for patients. What we're seeing is a dramatic drop in the time it takes to perform these procedures, and the AI is helping find more sperm than an embryologist without the AI. Hopefully towards the end of this year we can get our clinical trial done, dusted, and then hopefully by next year we can use that trial data for regulatory approval in Australia, and then we can start actually using it on patients."
It's not the only way AI is transforming reproductive technology.
In the 1990s Professor David Gardner developed the embryo grading system we use today and he's now the Scientific Director at Melbourne IVF.
Back then, embryologists would examine just one image.
Now the embryo's development is filmed as a time lapse, with AI used to analyse thousands of images.
"So what we do, is we grade our embryos using conventional means, and then we use the artificial intelligence to say, what do you think? And then we use it to augment our decision process. I think that's really important. We use it to supplement our decision. 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? We have a saying we want to get our pregnant sooner than later, not sooner or later, and with artificial intelligence, it means that we're making the right decision more often over which embryo to transfer first. Reducing time to pregnancy is a great outcome for patients because there's a lot of stress involved once they've had the transfer waiting for the pregnancy results, waiting by the phone to see if their bloods have come back and they're pregnant. And of course, if we can alleviate that in any way, that's a bonus."
Experts are also investigating whether AI could help personalise fertility medicine, by analysing our genes.
Professor Beverley Vollenhoven is the Head of Gynaecology and Research for Monash Health and is leading a study starting this year.
"What we wanted to look at is what effect genes may have on how a woman reacts to medication. We know that probably does, but it had never been looked at before. So what we're actually doing is something called whole genomic sequencing. So we are looking at a woman's entire genetic makeup and the AI part of it is to look at those genes. What we want to do with the use of this trial is to see that if we personalize the dose to that patient, that we get a better outcome or not. The ethical dilemma will be we are looking at someone's genes. What if we find something that is really abnormal, like they've got a risk of cancer, et cetera. Then we are bound to tell them that.”
In a statement to SBS the Australian Commission for Safety and Quality in Health Care said..
"...it's monitoring developments on the uptake and impact of [[AI]] technologies in the Australian healthcare system."
Meanwhile, for Reece and Annabelle the process continues.
"It's been a crazy journey, but we got some good news from my latest microtese. So we're really hopeful that this goes to plan. I think especially for males, it's just realizing that you are not alone. Realising that it is unfair and there's a lot of negative emotion and trauma that comes with that. But I really encourage men to really identify how they're feeling and work on it and be really open and honest and vulnerable and try and create really supportive networks. I think the more people you've got in your corner, the easier it makes the journey."
