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What We Do and Why We Do It. What We Do and Why We Do It Jumana Adham husseini Lab Director/Senior Embryologist. Our Bundles Of Joy. The Inside Story. Highest Pregnancy Rates In UAE. Semen Analysis. Liquefaction Volume Count /ml / (Total) Motility Progression Morphology Agglutination. - PowerPoint PPT Presentation
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WHAT WE DO AND WHY WE DO ITJUMANA ADHAM HUSSEINI
LAB DIRECTOR/SENIOR EMBRYOLOGIST
What We Do and Why We Do It
Our Bundles Of Joy
The Inside Story
Highest Pregnancy Rates In UAE
Semen Analysis
Liquefaction
Volume Count /ml /
(Total) Motility Progressio
n Morpholog
y Agglutinati
on
WHO (Criteria) 5th edition 2010-2013
Lower reference limit
Conc. 15m/ml (total 39m/ml)
Volume (1.5mls) Total motility 40% 32% progressive
motility Normal forms 4%,
(yet 15% normal forms defines teratozoospermia.)
Important Point to Remember
Severe reduction in fertilization might arise when < 4% strictly normal forms are present.
Abnormal spermatozoon under scanned microscope
Other Parameters Color Odor Opaque and grayish
white Changes to
yellowish white as days of abstinence ↑.
Blood gives it a reddish brownish color.
↓ conc. And WBCs ► transparent and watery consistency.
The odor of the flower of the chestnut plant.
Odor is caused by oxidation of the spermin secreted by the prostate.
Absence of odor ► Abnormal prostate function due to infection
The pH SHOULD BE WITHIN RANGE ( 7.2-8) Human semen should liquefy at pH
6.9-8.8 within 20- 30 minutes. > 8 → Acute prostatitis, vesiculitis or
bilateral epididymites. <7 → Obstruction of ejaculatory
ducts, only prostatic fluid secreted. <7.2-► <6 → chronic infection.
Liquefaction Vesiculase Seminine (Alpha) α-chymotrypsin Lysozyme Hyaluronidase α- Amylase Prostatic spec. antig. / prost. Acid
phos. None Liquefaction ≥ 1 hr. ► Prostatic
infection or other pathological state!?
1-FRUCTOSE
A sperm metabolite Done to check that ducts are normal.
Fructose levels are androgen dependant
↓Low levels →androgen deficiency
2- L-CARNITINE
Epididimal function is marked by L- carnitine. (↑ levels →none -Obstructive azoospermia. ↓ levels→ obstructive azoospermia. (post epididymal)
3- (PAP) Prostatic Acid Phosphatase
Prostatic Activity is Measured by seminal Acid Phosphatase (PAP)
↑ Acid phosphatase → obstructed ejaculatory ducts. (↓ semen volume, ↓ fructose.)
PAP test determines the health of the prostate.
Other tests4-Transferrin
5- Zinc and Selinuim
Sertoli cells are the source of 80%.
Very ↓ indicate Azoospermia.
↓ Low in oligospermia.
↑Highest in normal men.
Essential for germinal cell differ., and normal spermatogenesis, and sperm function.
Selenium deficiency leads to anomalies of neck and midpiece.
Zn ►chromatin decondensation.
Important Definitions Normozoospermia Oligoz0ospermia Asthenozoospermia Teratozoospermia Oligo-astheno-terato-
zoospermia Necrozoospermia Azoospermia Aspermia Cryptozoospermia
RECOMENDATIONS
Repeat /Semen AnalysisIUI/ IVF/ ICSISURVIVAL EVALUTIONVITALITY STAIN (EOSIN)SSU (♀♂) Selective swim upDNA FRAGMENTATION.SPERM ANEUPLOIDY
Vitality staining
The Sperm Marathon
From Fertilization to Implantation
EGG COLLECTION
Cumulus Oocyte Oopherus
Abnormal oocytes
Mature & Immature eggs
Photo of a very immature eggCorona and cumulus cells are tightly packed around the egg
IVF image of a mature egg on the day of egg retrievalWe call this the metaphase II, or "M2" stage The presence of the polar body (red arrow) shows that the egg is mature
IMPORTANT DEFENITIONS
IVF ICSI COMBINED
IVF/ICSI (split) CRYOPRESERVATI
ON (VITRIFICATION)
PESA/TESA/TESE
PGS PGD
...
IVF
ICSI
2PN stage Embryo
Embryos
THE HATCHING BLASTOCYST
THE DIFFERENCE BETWEEN IVF AND ICSI
IN IVF NATURAL SELECTION THE ZONA PELLUCIDA IS ABLE TO IDENTIFY GENETICALLY ALTERED SPERMATOZOA
GENETICALLY ALTERED SPERMATOZOA WITH POOR MOTILITY AND DNA DAMAGE HAVE LOW FITNESS IN OOCYTE FERTILIZATION
IN ICSI THE NATURAL PROCESS OF SPERM /OOCYTE INTERACTION IS BYPASSED.
PESA/TESA
(FNA)Fine Needle Aspiration
TESA / TESE
Cryopreservation