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Multipurpose Handling Media for IUI? Jayant G Mehta Director Sub-Fertility laboratory and Quality Control Manager Queen’s Hospital Romford UK

Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

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Page 1: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

Multipurpose Handling Media for IUI?

Jayant G Mehta Director Sub-Fertility laboratory and Quality Control Manager

Queen’s Hospital

Romford

UK

Page 2: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

IUI – Success Rates

Sperm Function dependent on the pH

Page 3: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

Laboratory Equipment for IUI

Page 4: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

pH – buffering range

Page 5: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

Multipurpose Handling Medium

and H

Contains: MOPS and HEPES

Page 6: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

Sperm Preparation for IUI

Preparation for intrauterine insemination (IUI)

is to obtain

– large number of motile sperm

– the most fertilizable population of sperm

Page 7: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

DENSITY GRADIENT

New line of density gradient products have

been manufactured, specifically,

– colloidal silica particle-based density gradients

ISolate®

PureSperm®,

Page 8: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

ISOLATE

Page 9: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

Objectives of the Preliminary Study

Compare two sperm wash media:

– Quinn’s (Origio) and MHM (Irvine Scientific)

Compare 24 hrs survival

Pregnancy with MHM

Compare two gradient separation materials:

– ISolate (Irvine Scientific) and Puresperm (Nidacom)

Higher motile sperm yield

Page 10: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

Design of the Study

Four arms to the study.

– 1. ISOLATE and MHM medium

– 2. ISOLATE and Quinn’s sperm wash medium

– 3. PURESPERM and MHM medium

– 4. PURESPERM and Quinn’s sperm wash

Recovered count

% motile count

% 24 hrs survival of progressive motile sperm

Page 11: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

Inclusion Criteria

Semen sample > than 3 mls

Sperm count > 40 million per mL

Sperm progressive motility > 50%

Page 12: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

Method

Sample allowed to be liquefied for 20 minutes

at 37 C

Discontinuous gradients prepared (40% and

80% of ISOLATE® and PURESPERM®)

Allowed to stand in a heating block at 37 C.

Sample divided into two equal parts

Each part minimum volume 1.5 mls

Page 13: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

Mean Sperm Count Recovery (Mil/mL)

Age No of

Patients

(n=50)

Mean Count

Recovered

with

ISOLATE ±

SD

Mean Count

recovered

with

PURE

SPERM ± SD

% Pregnancy

After

insemination

using

ISOLATE and

MHM

25-30 13 12.5 ± 2.3 9.0 ± 2.6 15.4 (2/13)

30-35 20 17.8 ± 3.4 12.7± 3.2 25.0 (5/20)

36-40 12 17.3 ± 2.9 11.8 ± 2.1 8.3 (1/12)

>40 05 18.0 ± 3.7 11.0 ± 2.4 0.0 (0/5)

Page 14: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

Mean % Motile Sperm Recovery – ISOLATE/24hrs survival

Age No of

Patients

(n=50)

Mean %

Motile

recovery

washed with

MHM (1)

± SD

Mean %

Motile

recovery

washed

with

Quinn’s (2)

± SD

Mean % 24

hrs

progressive

survival(1)

± SD

Mean % 24

hrs

progressive

survival(2)

± SD

25-30 13 90.8 ± 5.8 91.3 ± 7.2 74.5 ± 4.3 63.4 ± 8.2

30-35 20 88.4 ± 4.4 82.4 ± 5.6 70.3 ± 6.2 59.5 ± 7.4

36-40 12 90.1 ± 3.2 81.3 ± 6.6 77.4 ± 7.4 57.6 ± 6.5

>40 05 91.2 ± 3.6 84.2 ± 4.2 77.5 ± 6.4 58.7 ± 8.3

Page 15: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

Mean % Motile Sperm Recovery PURESPERM/24hrs survival

Age No of

Patients

(N=50)

Mean %

Motile

recovery

washed

with MHM

(3) ± SD

Mean %

Motile

recovery

washed

with

Quinn’s

(4) ± SD

Mean 24

hrs

progressi

ve

survival

(3) ± SD

Mean 24

hrs

Progressi

ve

survival

(4) ± SD

25-30 13 89.6 ± 6.7 86.7 ± 4.7 72.7 ± 3.7 57.9 ± 5.9

30-35 20 88.8 ± 4.6 85.9 ± 5.1 70.3 ± 5.3 58.4 ± 6.2

36-40 12 88.2 ± 7.2 82.3 ± 6.9 72.5 ± 7.2 60.3 ± 7.2

>40 05 90.1 ± 4.6 80.2 ± 5.3 75.8 ± 4.6 58.6 ± 6.3

Page 16: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

CONCLUSION

Statistical analysis not possible due to low

number of patients

Trend suggests:

– ISOLATE separation yields higher progressive

motile sperm

– MHM washed sperm had higher mean% of

progressive 24 hrs survival

– This combination resulted in pregnancies.

– Possible reason pH regulation with MOPS and

HEPES?

Page 17: Multipurpose Handling Media for IUI? · Multipurpose Handling Medium (MHM) for IUI Author: Jayant Mehta Keywords: MHM, Multipurpose Handling Medium, MHM-C, ISolate, sperm wash, intrauterine

FUTURE

A larger study

Look at the influence of MHM on sperm

kinetics