Objective: To evaluate the agreement of motile sperm concentration (MSC) measurements obtained using the YO Home Sperm Test compared with manual semen analysis and computer-assisted semen analysis (CASA), and to assess its potential utility as a home-based screening tool for male fertility. methods: the YO Home Sperm Test, manual semen analysis with a Makler counting chamber, and CASA using the Integrated Visual Optical System analyzer. Agreement between methods was assessed using intraclass correlation coefficients (ICCs) with 95% confidence intervals (CIs).Results: The three testing methods showed significant correlations (p<0.01), with an overall ICC of 0.902. Pairwise ICCs were 0.815 (95% CI, 0.651 to 0.902) between manual semen analysis and the YO Home Sperm Test, 0.793 (95% CI, 0.608 to 0.890) between manual semen analysis and CASA, and 0.944 (95% CI, 0.894 to 0.970) between the YO Home Sperm Test and CASA. Agreement was strongest between the YO Home Sperm Test and CASA, supporting the reliability of the home-based device for measuring MSC.Conclusion: The YO Home Sperm Test demonstrated good agreement with both manual semen analysis and CASA, particularly with CASA, supporting its potential use as a convenient, accessible, and private screening tool for the initial evaluation of male fertility. However, as a screening device rather than a comprehensive diagnostic test, abnormal findings should be confirmed by standard laboratory semen analysis. Further studies in larger populations and across different smartphone platforms are warranted.
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