ExSeed Accuracy for Sperm Analysis
ExSeed is a reasonably accurate smartphone-based home sperm test that can effectively screen for low versus normal motile sperm concentration, but it cannot replace comprehensive laboratory semen analysis and should only be used as an initial screening tool to determine whether formal laboratory evaluation is warranted. 1
Evidence for ExSeed Accuracy
ExSeed is one of three commercially available smartphone-based devices (along with YO® and SEEM®) that can accurately measure sperm volume, concentration (millions/mL), and total motile sperm count in a user-friendly manner 2
While ExSeed specifically has limited published validation data, similar smartphone-based devices like YO have demonstrated 97.8% accuracy with positive and negative percent agreement above 94% when compared to laboratory analyzers (SQA-Vision) for motile sperm concentration up to 94 × 10⁶/mL 3
These devices show good correlation (Pearson coefficient above 0.92) with laboratory equipment and can effectively detect samples with abnormally low motile sperm concentration below 6 × 10⁶/mL 3
Critical Limitations You Must Understand
Home tests like ExSeed do not assess sperm morphology, which is a key component of WHO-based semen analysis and may be associated with DNA integrity issues 1
Single home test results should never be used for definitive diagnosis, as clinical guidelines require at least two properly performed semen analyses at least one month apart to account for biological variability 1
Home tests showing normal results do not rule out male factor infertility, as 25% of infertility cases remain unexplained despite normal conventional parameters 1
Proper Clinical Integration
If ExSeed suggests abnormality, formal laboratory evaluation with two semen analyses is mandatory before making any treatment decisions or diagnoses 1
Collection timing matters critically—patients must abstain from sexual activity for 2-3 days before collection, as inadequate abstinence significantly affects volume and concentration, invalidating results 1
The sample must be examined within one hour of collection, as delayed analysis affects motility assessment 1
Even with normal ExSeed results, comprehensive evaluation including endocrine testing (testosterone and FSH if concentration <10 million/mL), physical examination, and reproductive history is still required 1
Context: Why Laboratory Quality Matters
Many clinical laboratories themselves fail to adhere to WHO standardized methods, with quality control programs documenting poor adherence across andrology laboratories worldwide 4, 5
Between-laboratory coefficients of variation can be extremely high—ranging from 20.8-33.8% for concentration and 54.2-70.2% for morphology—even among professional laboratories 6
Individual technician variability is substantial, with coefficients of variation reaching 44.3% for sperm concentration measurements on the same sample 7
Bottom Line for Clinical Use
Use ExSeed as a convenient initial screening tool for men who face barriers to clinic-based testing due to embarrassment, cost, or accessibility issues 1
The device can cost-effectively select patients who need formal laboratory evaluation and potentially identify candidates for first-line treatments like intrauterine insemination 2
However, ExSeed lacks the comprehensive quality control programs and trained personnel oversight that high-quality laboratories provide, and cannot assess the complete fertility profile needed for definitive diagnosis 1