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SEMEN PREPARATION for IUI SEMEN PREPARATION for IUI

SEMEN PREPARATION for IUI - PowerPoint Presentation

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Uploaded On 2017-06-13

SEMEN PREPARATION for IUI - PPT Presentation

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

semen gradient centrifugation technique gradient semen technique centrifugation swim normal media parameters evidence wash comparing sperm pellet trials preparation

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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 minimisedSlide11
Slide12

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