Abstract Study question Can Mojo AISA, an Artificial Intelligence microscopy, release accurate and reliable semen analysis results for the daily routine? Summary answer Mojo AISA guarantee precise semen analysis results improving the objectiveness and minimizing human error. Moreover, embryologists can safe 50% of time per procedure. What is known already The current method to perform a semen analysis is through the manual microscope and/or computer-assisted semen analysis. The most automated sperm analyzers rely on a classic image processing algorithms which can distinguish spermatozoa by size and brightness. However, it has been demonstrated that these algorithms are not able to discriminate well spermatozoa heads from other cells that have similar size, leading to improper results. To overcome these limits, a new Artificial Intelligence Semen Analysis system, Mojo AISA, has been developed to carry out concentration and motility. Mojo AISA is based on a neural network classification, a series of embedded algorithms. Study design, size, duration In the last nine months, semen parameters of 64 men were assessed simultaneously by manual microscopy method and by Mojo AISA. The manual semen analysis was performed by two certified andrologists following WHO 5th Edition guidelines. Concentration and motility parameters were assessed and compared between the two methods. Regarding the motility, we compare the following 3 categories: Progressive (PR), Non-Progressive (NP) and combined motility (PR+NP). Samples with normal and abnormal semen parameters were included. Participants/materials, setting, methods Semen samples were allowed to liquefy for at least 15 min at 37°C. For the manual method, 10 μL of raw sample was loaded onto a Makler chamber and for Mojo AISA, two 10 μl drops of raw samples were smeared side on the side on a glass slide. Mojo AISA delivered semen analysis results in 4 minutes per sample. The statistical analysis was carried out with SPSS 14.0 statistical software. Main results and the role of chance A semen analysis of 64 semen samples from 62 men (40±10 years old) was performed simultaneously with manual method and Mojo AISA, following WHO 5th Edition (2010) guidelines. The average and the standard deviation of semen concentration with manual method and with Mojo AISA was 52.7±46 and 50.6± 43.2 x 106/ml, respectively (P=NS). No significant difference was found when the combined motility (PR+NP) was evaluated. Indeed, the average and standard deviation was 53.5±20% with manual method and 49.1± 22.1% with Mojo AISA (P=NS). Similar results were seen with progressive motility showing an average and standard deviation of 38.5±19% and 34.1±20%, respectively (P=NS). Ultimately, the assessment of non-progressive motility showed an average and standard deviation of 12.3±12% with manual method and 13.9± 9% with Mojo AISA, showing no statistic difference. Limitations, reasons for caution The protocol of the slide’s preparation should be properly followed since the formation of air bubbles can impact on the correct semen evaluation of Mojo, misleading sperm results. Mojo AISA presents difficulty to assess sample with extremely low concentration and further evaluation are needed for this type of samples. Wider implications of the findings These findings show that the semen analysis results of mojo AISA and those of manual method are comparable. Mojo AISA can guarantee semen analysis results more precise, with lower inter-laboratory variability and in a 50% shorter time. Trial registration number N/A
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