Dr Aruna Saxena MDObsamp GynaeARTCE NUS Singapore Director Lifecare IVF Pvt Ltd SEMEN PREPARATIONWhy Washing removes seminal plasma prostaglandins Prolonged exposure to seminal plasma inhibits ID: 559163
Download Presentation The PPT/PDF document "SEMEN PREPARATION for IUI" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
SEMEN PREPARATION for IUI
Dr Aruna SaxenaMD(Obs& Gynae),ARTCE (NUS, Singapore)Director ,Lifecare IVF Pvt LtdSlide2
SEMEN
PREPARATION-Why ?Washing
removes seminal
plasma (prostaglandins) .Prolonged exposure to seminal plasma inhibits
capacitation of spermDead sperm and pus cells produce harmful ROS (Reactive oxygen species)Selects for motile sperm.Slide3
SEMEN COLLECTION AND DELIVERY
WHO recommendation
3-5 days of abstinence
Masturbation
Clean wide mouth sterile containerLabelingFirst portion of ejaculate should not be lostCollection in non spermicidal condom following intercourse Slide4
Normal values for WHO manuals
(editions 2-5)
4Slide5
Which technique ?
GOOD : Parameters normal /> normalBAD : Parameters less than normalUGLY : Parameters severely low, viscous , infected , agglutination
NO SPERMS : high speed centrifugation
VERY LOW COUNT : Pooling of samplesSlide6
PELLET - SWIM UPSlide7
PELLET - SWIM UPSlide8
Pellet
Semen
45% gradient
90% gradient
Media
Spin
Density gradientSlide9
Media
Semen
Underlay
MigrationSlide10
INSTRUCTIONS TO BE FOLLOWED WHILE HANDLING SEMEN SAMPLE
Clean sterile work area (Laminar air flow)Non-toxic, non-powdered gloves Slow Dilution
Pre warm media and disposables
Preparation performed at 37`c
Thorough identification protocol Damage to the sperm from dilution, temperature change.centrifugation,and exposure to potentially toxic material must be minimisedSlide11Slide12
Semen préparation techniques for intrauterine insémination
(Review)Boomsma CM, Heineman MJ, Cohlen BJ, Farquhar CThe Cochrane Library 2009, Issue 1
Five RCTs, including 262 couples in total, were included in the meta-analysis
No 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.
12Slide13
Authors’ conclusions
There 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.
13Slide14
IN HOUSE IUI FACILITY
FOR BEST RESULTSSlide15
Your Questions are Welcome