SEMEN PREPARATIONfor IUI

SEMEN PREPARATION for IUIDr Aruna SaxenaMD(Obs& Gynae),ARTCE (NUS, Singapore)Director ,Lifecare IVF Pvt Ltd

SEMEN PREPARATION-Why ?Washing removes seminal plasma (prostaglandins) .Prolonged exposure to seminal plasma inhibits capacitation of sperm

Dead sperm and pus cells produce harmful ROS (Reactive oxygen species)

Selects for motile sperm.

2SEMEN COLLECTION AND DELIVERYWHO recommendation 3-5 days of abstinenceMasturbationClean wide mouth sterile containerLabelingFirst portion of ejaculate should not be lostCollection in non spermicidal condom following intercourse

Normal values for WHO manuals (editions 2-5)

4Which technique ?GOOD : Parameters normal /> normal

BAD : Parameters less than normal

UGLY : Parameters severely low, viscous , infected , agglutination

NO SPERMS : high speed centrifugation

VERY LOW COUNT : Pooling of samples

PELLET - SWIM UP

PELLET - SWIM UP

Pellet

Semen

45% gradient

90% gradient

MediaSpinDensity gradient

MediaSemenUnderlay

Migration

INSTRUCTIONS TO BE FOLLOWED WHILE HANDLING SEMEN SAMPLEClean sterile work area (Laminar air flow)Non-toxic, non-powdered gloves Slow Dilution Pre warm media and disposablesPreparation performed at 37`cThorough identification protocol

Damage to the sperm from dilution, temperature change.centrifugation,and exposure to potentially toxic material must be minimised

Semen prparation techniques for intrauterine insmination (Review)Boomsma CM, Heineman MJ, Cohlen BJ, Farquhar CThe Cochrane Library 2009, Issue 1Five RCTs, including 262 couples in total, were included in the meta-analysisNo trials reported the primary outcome of live birth.There was no evidence of a difference between pregnancy rates (PR) for swim-up versus a gradient or wash and centrifugation technique,Nor in the multiple PR in two studies comparing a gradient technique versus wash and centrifugation.There was no evidence of a difference in the miscarriage rate in two studies comparing swim-up versus a gradient technique.12Authors conclusionsThere is insufficient evidence to recommend any specific preparation technique. Large high quality randomised controlled trials, comparing the effectiveness of a gradient and/ or a swim-up and/ or wash and centrifugation technique on clinical outcome are lacking.Further randomized trials are warranted.13IN HOUSE IUI FACILITY

FOR BEST RESULTSYour Questions are Welcome