I think bicycle saddles are quite advanced. I’ll echo whats been said above and say that the fit is the real problem, not design or tech.
So how can we get a better fit? (aka the correct saddle and adjustment) Right now the best method seems to be ischium (sit bone) measurements. In the store I work at we have “devices” from both specialized and bontrager for finding this measurement. Sometimes they work pretty well, and other times they don’t work at all. Clothing type of the user seems to affect it a lot. Perhaps we could come up with something better than a foam pad for measuring this? There have to be other measurable factors in the fit… what else?
Another big piece of the puzzle is user education. How do you get the user to understand that a big puffy saddle will end up hurting them on any ride over a couple of miles? How do you get them to not mess with the angle or fore/aft adjustment once a certified fitter has set it? These are really the things that I’ve encountered as the cause of discomfort for my customers.
[FWIW, I have ridden a Specialized Toupe gel since '10 for rides up to 70 miles and haven’t had a problem. My new bike came with a Romin and I’m liking it so for too. As for customers, I sell a lot of bontrager SSR’s to casual riders. Recently I’m finding the Specialized Riva to be great bang(fit) for the buck for more competitive/aggressive riders]