Semen Analysis and Post Vasectomy Diagnostic using a Smartphone?

An article from March 22 2017 Science Translational Medicine authored by Manoj Kumar Kanakasabapathy¹ et al reports on the development of a combination of smartphone software combined with additional, relatively inexpensive hardware, that can be used to perform a portion of a semen analysis (at home).  

Standard semen analysis includes an assessment of sperm concentration, motility (percentage of sperm moving and quality with which they move) and morphology (shape of the sperm).   The new device/software is able to perform an assessment of concentration and motility of the sperm with over a 95% accuracy in terms of whether the specimen does or does not fulfill WHO criteria for a normal specimen (based on only concentration and motility).

The illustration above is taken directly from the publication. http://stm.sciencemag.org/content/9/382/eaai7863/tab-figures-data

As shown in the attached illustration,  the specimen is loaded into a chamber which uses capillary action to pull it in.  The chamber with specimen is then placed into a plastic cradle which holds it in position.  A smart phone is then placed in the same cradle positioning its camera over the specimen.    The cradle also has an optical attachment to modify the ability of the smartphone to “see” the sperm as well as an LED light source, a battery and a microchip.  The components were reported to cost less than $10. 

Dr. Seaman’s comments/concerns:

1. With respect to post vasectomy semen analysis,  there does not seem to be a cost savings as reimbursement for the test averages around $10-$20 as it is.   The number of samples with <=100,000 sperm/ml actually tested according to the article also appears low.   Still, if the test is better validated, and if the user is comfortable with a “small” chance of error, this could become a viable application.
2. With respect to routine semen analysis, concerns include: no assessment of sperm morphology and some intrinsic error rate.  In fact the data show results to be less accurate with higher sperm density.  Motility is also performed in a manner similar to computerized assisted semen analysis (CASA)  while the majority of clinics use a manual assessment.   Still, if this is a tool that would motivate or enable potential patients with a problem to come in to be evaluated, then I think this could be a very powerful tool.
3. Comparison with other take home tests shows this likely is (will be)  superior.  Current home tests include are FertilMARQ and SpermCheck, which use an assay to detect certain sperm-specific proteins.   Trak,  which was recently released, uses a mini-centrifuge centrifugal force to estimate sperm concentration and  has a similar accuracy for determining normal sperm concentration defined as greater than or equal to 15 million sperm/ml. However, none of these tests measure sperm motility.
4. Kudos to the authors for this impressive adaptation of cell phone technology to the medical space.  Can’t wait to see what else they come up with.