Dr David Crosby
Clinical Director and Consultant Obstetrician & Gynaecologist,
Dr Aoife Campbell
PhD – Innovation Manager
Dr Louise Glover
PhD – Head of Research
As our understanding of male fertility evolves, research and innovation are opening new opportunities to improve how sperm is being assessed, selected and supported.
“The narrative around fertility can sometimes be that it is primarily a female problem,” begins Dr Aoife Campbell, Innovation Manager at Merrion Fertility Clinic. “Increasingly, however, research is looking at the biology of sperm and how male health can influence sperm quality and reproductive outcomes.”
This shift is prompting a closer look at what factors influence sperm quality and function, driving research into areas such as nutrition, sperm selection and male reproductive health. The clinic, investigating how environmental influences affect male fertility and reproductive health, is using such evidence to evaluate and introduce technologies within its own practice.
Cutting-edge sperm selection technology
According to Campbell, the question is increasingly moving from ‘How many sperm are there?’ to ‘Can we identify sperm with the characteristics associated with better reproductive potential?’
ZyMōt is one such technology, taking a different approach to conventional sperm separation. It has been designed to better reflect the biological process of sperm mobility. “Rather than relying on techniques that physically process and filter sperm samples,” explains Campbell, “ZyMōt is a separation device, which allows the sperm to swim through a filter, letting biology guide the process to ensure that we are selecting the highest quality, most motile sperm.”
Computer-aided specialist support
Technology is also being explored to address one of the most challenging situations in male fertility: finding sperm when very few are present. MicroTESE is an advanced surgical procedure used to retrieve sperm directly from the testicles of men with non-obstructive azoospermia, where sperm production is extremely limited.
Merrion Fertility Clinic is exploring how computer-aided vision could support scientists during this process. The software analyses images of the sample and flags structures that may be sperm. An embryologist can then assess them. “This isn’t about replacing the embryologist or allowing a computer to make autonomous decisions,” explains Campbell. “It is about utilising advancing technology to support specialists with a task that can traditionally take hours under a microscope, where there are often only a very small number of sperm to find.”
We don’t want to create additional barriers by charging patients
for access to a technology like ZyMōt that could meaningfully benefit their care
Extensive, long-term semen assessments
At the heart of this approach is a commitment to ensuring that new technologies translate into meaningful outcomes. “For us, innovation isn’t about introducing something new for the sake of it,” explains Dr Louise Glover, Head of Research. “It’s about understanding the underlying biology, using that knowledge to improve what we do, and ultimately asking whether it makes a meaningful difference to patient care and outcomes.”
The clinic’s commitment to evidence-based innovation is illustrated by its 16-year evaluation of over 18,000 semen analyses from over 15,000 men attending the clinic between 2008 and 2023. While global studies have reported declining semen quality, their own patient data showed a 22.8% increase in median sperm concentration.
“We are also revisiting Physiological Intracytoplasmic injection, PICSI, a hyaluronic acid binding technique which helps identify mature sperm capable of successful fertilisation,” continues Glover. “Research has suggested a potential benefit of lower miscarriage rates, and our team is investigating how these findings might translate into our own patient population.”
Improving access to specialised services
ZyMōt has been introduced into Merrion Fertility Clinic without any additional charge to patients. They are working with two Consultant Andrologists to improve access to microTESE, a highly specialised service. “Fertility care should be evidence-based and accessible according to clinical need, not a patient’s ability to pay,” explains Glover. “Fertility treatment is already expensive. We don’t want to create additional barriers by charging patients for access to a technology like ZyMōt that could meaningfully benefit their care.”
This collaborative approach extends beyond access, bringing together fertility, urology and andrology expertise through its multidisciplinary team to discuss complex cases, building specialist knowledge on topics including fertility preservation and the potential use of microTESE in young men facing loss of fertility after cancer treatment.
To find out more, go to: https://merrionfertility.ie/
