P-017 Validation of origami microscope “Foldscope” as a preliminary screening tool for male infertility

Abstract Study question Is there a concordance between the new optical microscope based on origami (Foldscope) with a traditional microscope for semen analysis as a screening method? Summary answer There is a 91% direct concordance between the foldscope and a traditional microscope as screening for initial approximation to male infertility. What is known already Semen analysis is a key element on men fertility evaluation. In order to obtain a semen sample, patients have to assist to a fertility clinic where the sample is analyzed. However, due to either time or distance problems, many patients cannot attend to fertility clinics. On the other hand, Foldscope is an origami-based microscope that can provide over 2000x magnification, and it can be attached to a smartphone and take photos and videos, which can be sent to fertility specialists for analysis. This technology might provide important information about semen status, especially in areas with limited fertility care access. Study design, size, duration A retrospective observational study was carried out, we included semen samples obtained by masturbation from volunteers were analyzed for count, concentration, and motility from patients who were undergoing a fertility study between November 2021 and November 2022 in Clínica Alemana, Santiago, Chile. Participants/materials, setting, methods A total of 188 human semen samples were evaluated by a single embryologist under a standard microscope and later used the same sample to make a cell phone video with Foldscope. This information was randomized and the videos were subsequently analyzed by the same embryologist blindly. Finally, the matching of the results was carried out. Main results and the role of chance Moderate and significant positive correlation for concentration calculated as > or < 15 million/ml between Conventional Microscopy and Foldscope (correlation coefficient= 0.67, p < 0.005) Sperm motility for progressives A+B recorded with Foldscope demonstrated a significant correlation with the traditional microscope results (correlation coefficient = 0.69, p < 0.005). Finally, the concordance for the sperm count between both methods was 91%, with a kappa index of 0.66 (p < 0.0001). Limitations, reasons for caution One of the most important limitations of semen analysis by foldscope is that it must be interpreted by an embryologist, which means that the images must be sent to a specialized center. Wider implications of the findings In countries with few economic resources and not many options to for reproductive medicine centers, the use of the foldscope microscope as a screening as an initial approximation to male fertility allows a quick and economical immediate referral to men with reproductive problems. Trial registration number not applicable