Hopes of fatherhood: UBC scientists on frontier of high-tech male infertility research
Treatments like chemotherapy can leave cancer survivors infertile, but new research aims to change that
A team of researchers at the University of British Columbia (UBC) is using artificial intelligence in an effort to detect hard-to-find sperm and 3D bioprinting technology with the ultimate goal of growing sperm in the lab — technologies they say could eventually help men with infertility become parents.
The research, led by Dr. Ryan Flannigan, a urologist and associate professor at UBC, is aimed at addressing a "severe form" of male infertility called non-obstructive azoospermia (NOA), in which the body produces little to no sperm.
It's a condition that affects about one in 100 men, many of whom are survivors of childhood cancer, according to Flannigan.
"There's a big problem with infertility: it's so common," he told CBC's The Early Edition. "Something that I see time and time again is just how much of an emotional toll having challenges with infertility is."
According to a UBC media release, about two thirds of male pediatric cancer survivors will face infertility in adulthood, due to the effects of radiation or chemotherapy. Globally, one in six couples struggles to conceive, and male infertility, broadly, plays a role in about half of those cases.
AI to detect rare sperm
Currently, the only treatment for NOA involves surgically extracting testicular tissue and searching for hard-to-find sperm under a microscope — a tedious process, says Flannigan, that can take hours and still might end in failure.
"It's ... looking for a needle in a haystack," he says. "Right now, we're able to find sperm about 50 per cent of the time. We ideally need to find at least one sperm per each egg, among millions of other cells, which takes hours."
To improve the odds, Flannigan says he and UBC engineering professor Hongshen Ma have developed an AI-powered tool that scans microscopic images to flag viable sperm for use in in vitro fertilization (IVF).
The technology is still a long way from being available for people struggling with male infertility — Flannigan expects clinical trials for the AI tool could begin within the next three to five years.
Lab-grown sperm for those without options
But for people who produce no sperm at all, including children who undergo cancer treatment before puberty and are unable to store sperm, a more experimental avenue is underway: lab-grown sperm.
In what the UBC media release calls a world-first, Flannigan and team have bioprinted a model of human testicular tissue using stem cells and a specialized gel-like "bio-ink."
The printed structure replicates the tiny tubes in the testes where sperm are normally produced. These bioprinted 'mini testicles' are encased in a special gel filled with specific nutrients and vitamins to help them mature.
According to researchers, some of the cells have already begun showing signs consistent with the early stages of puberty — "a time when sperm production starts occurring in the human body."
"What we're trying to do with 3D bioprinting is recreate what's happening in a healthy testicle as accurately as we can," said Flannigan.
"If we can determine what the cells need to progress through all the phases of sperm production, we can use that knowledge to figure out how to create sperm for a patient with NOA," says Dr. Flannigan.
The work is being supported by experts in microfluidics — a system that manipulates a small amount of fluids — and cancer biology at UBC and the University of Victoria, who are helping identify the molecular conditions required for sperm to develop.
Still, researchers acknowledge there are significant challenges ahead. According to the UBC release, sperm production is a "highly complicated process" involving multiple cell types, complex anatomical structures, making it a task that demands collaborative, multidisciplinary research.
'Life-changing' potential, but questions remain
Laura Spencer, a fertility coach in Vancouver, has experienced the emotional toll of infertility first-hand in her own family.
"I've gone through infertility — male factor infertility in particular — and it's devastating," she told CBC News. "There's nothing quite like it."
She said this latest development in treating male infertility could potentially be life-changing for many couples.
"This shows a lot of promise for people who might not have the ability to try and conceive … they might actually be able to have a baby."
Spencer says male infertility remains a taboo subject, despite being a factor in about half of all couples struggling to conceive. She hopes this research not only opens new medical doors, but also breaks down stigma.
"There is a lot of shame and sometimes guilt around that," she said. "I'm always grateful when the conversation turns to infertility and when it's normalized."
While Spencer believes most people would welcome these technologies, she says it's important to acknowledge the complexity involved, particularly with lab-grown sperm.
"There will definitely need to be education around this," she added. "We don't know what the long term consequences are of this technology. Are there any birth defects that are possible? What about when they grow up? Like we don't know. This is just so new."
As for concerns about the safety of AI or stem cell-based procedures, Flannigan says the research team is taking a cautious approach.
"It's one of these things that we need to ensure that we follow all the guidelines to ensure there's no biases," he said.
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With files from The Early Edition