Why is it necessary?
Sperm must be washed before it can be used for IUI as raw semen cannot be inserted
directly into a woman’s uterus. Why? semen contains chemical substances
called prostaglandins which cause muscular contractions and are responsible
for cramps during menstruation and pregnancy. If raw semen is inserted directly
into the uterus , it could cause severe pain and cramping causing shock.
It could also cause your uterus to collapse, causing severe complications.
Sperm washing can also get rid of the white blood cells,
mucous and seminal fluid surrounding the sperm, which can
also interfere with fertility.
Pre-procedure instructions
The sperm wash procedure is actually relatively easy to prepare for. Your semen
will be collected after you masturbate, or from a sample taken during surgical
sperm retrieval. It is important to refrain from sexual intercourse for 2-4
days before your sperm is collected. this gives the semen time to build in
volume. History of recent use of antibiotics must also be provided if applicable
as some do interfere with semen.
Sperm Washing Procedures
The Sperm Wash
is the most important factor in achieving pregnancy through
IUI, since the quality of the wash will
ultimately determine the total amount of motile sperm recovered.
This makes the type of wash technique used for the patient
even more important to make sure every possible sperm is
recovered. In order to achieve the best possible results,
each wash procedure needs to be "custom tailored" for
each individual patient to maximize sperm recovery. This
is based on a critical examination of "pre-wash" semen
fluid analysis.
Commonly used sperm washing procedures include:
Simple Sperm Wash
This is the most basic way of washing and preparing sperm for IUI. Semen is
diluted in a test tube with a special solution of antibiotics and protein
supplements. It is then spun in a centrifuge. Sequel to this, sperm cells
aggregate at the bottom of the test tube, producing a mass of dense, highly
active sperm. These sperm can then be removed from the test tube and used
in IUI. A simple sperm wash takes approximately 30 minutes.
Gradient Sperm Wash
This method goes an extra mile as the gradient wash media acts as a filter
separating dead sperm cells, white blood cells, and other waste products
from the sperm.
A test tube is filled with multiple layers of liquids
of different densities. Semen is then placed on the top
layer of liquid and the test tube is spun in a centrifuge.
After it is spun, active, healthy sperm will migrate to
the bottom layer of liquid in the test tube, while debris
and dead sperm will get caught in the top two layers. These
layers can be siphoned off in order to remove the active
sperm from the test tube. This sperm is then used in the
IUI procedure. Gradient sperm washes take approximately
60 minutes.
Swim Up Technique
This technique aims to use only the most powerful sperm will be able to do
this. In order to retrieve this powerful sperm, semen is placed in a culture
dish with a layer of media culture. Sperm are attracted to this culture,
and will swim up to it. As the sperm swim up to the culture, they are collected.
This technique takes about two hours in order to collect enough sperm for
use.
A post-wash semen analysis is then performed to determine
the final outcome of the procedure and to calculate the
total number of motile sperm in the IUI prep, which is
now ready for insemination.
Success Rates
Since sperm washing ensures that only the most healthy and active sperm are
used for fertilization, there is an increased chance that pregnancy will
occur when using washed sperm. However, success rates do depend on overall
sperm count. Typically, the lowest sperm count to be used with sperm washing
is one million. The best sperm counts for use with sperm washing are those
between 20 and 30 million.
|
