AI technologies outperform traditional methods for semen analysis in male infertility

Infertility is defined as the inability of a sexually active couple, not using contraception, to achieve a spontaneous pregnancy within 12 months. It affects an estimated 8% to 12% of couples worldwide, with 30% to 50% of cases attributable, either primarily or in part, to male factors. Despite the increasing number of assisted reproductive technology (ART) procedures performed globally, improvements in fertilization and pregnancy outcomes have been limited. The need to improve diagnostic accuracy and therapeutic efficiency has driven the development of artificial intelligence (AI) in reproductive medicine. This narrative review aims to explore how AI is transforming the diagnosis and treatment of male infertility. AI technologies are nowadays being used to automate and refine semen analysis, providing more reliable assessments of sperm morphology, motility, and concentration. These innovations enable clinicians to improve the prediction of semen quality and to identify which patients might benefit most from specific interventions, such as sperm retrieval in cases of non-obstructive azoospermia or the selection of optimal sperm cells for reproductive techniques. Moreover, advanced AI algorithms—including support vector machines, deep neural networks, and decision trees—outperform traditional methods, offering greater precision and reducing subjectivity in laboratory evaluations. Additionally, AI is being utilized to estimate the chances of success with assisted reproductive techniques, assess sperm DNA fragmentation, and guide the selection of sperm. The integration of AI into clinical practice not only enables more accessible and personalized diagnoses but also opens new perspectives for the development of individualized treatments, optimizing reproductive outcomes. However, further multicenter validation of AI-based models, methodological standardization, and careful consideration of ethical and privacy issues are necessary before widespread clinical adoption.