ABSTRACT
Objective: Infertility is a serious disease requiring timely treatment. If treatment is delayed, the condition of patients may deteriorate over time. The coronavirus (COVID-19) pandemic has seriously affected couples in need of immediate infertility treatment. Because of stay-at-home guidance, fewer people are visiting medical facilities, and thus it may become necessary to provide online medical services, including infertility treatment. Male-factor infertility contributes to about 50% of the incidence of infertility in couples. Semen analysis is key to diagnosing reproductive potential in men. In current practice, men must visit a clinic or other medical facility for semen analysis. However, there are cases in which visiting a medical facility is problematic, as in the current pandemic. To address this issue, many devices for at-home testing of semen samples have been developed and commercialized. We have developed a service enabling infertility patients to receive medical advice by allowing them to easily share at-home smartphone semen test data with embryologists. To verify the effectiveness of this system, we evaluated the correlation between at-home smartphone semen test data analyzed by embryologists and semen test results measured by computer assisted semen analysis (CASA). Design: Laboratory investigation. Materials and Methods: We developed an online system that allows sperm videos captured using a smartphone microscope to be uploaded and shared with embryologists. After receiving training on the online system, the embryologists viewed the videos on a large computer screen and recorded motile and static sperm counts. Because the appearance of sperm captured in videos can differ depending on the type of smartphone, the embryologists measured sperm concentration and motility by estimating the size of the sperm head and tail. A total of 45 human semen samples were analyzed using both the developed system and CASA software. Each test was evaluated for compliance with World Health Organization semen testing criteria. Results: Sperm concentration measured using the online system showed a very strong correlation with CASA results (P < 0.01, r = 0.89). Sperm motility analyzed by embryologists using the online system were significantly correlated with CASA results (P < 0.01, r = 0.74). Conclusions: Online medical care will likely become increasingly important during the COVID-19 pandemic. The system we developed is a useful service allowing infertility patients to share at-home semen test data with embryologists. Analysis of the test data by embryologists resulted in few mistakes compared with automatic machine analysis. The system enables patients to connect with doctors and receive medical treatment online. Services like this one could be become more common in the future.