Sperm Collection & Washing
When couples encounter difficulty conceiving a pregnancy and have arrived at the place of seeking help, often the first type of fertility treatment attempted is intrauterine insemination, or IUI. There are specific procedures which must be followed in order to prepare for IUI which include timing of ovulation and the preparation of the sperm for insemination.
Preparing For IUI
It is not necessary that a man abstain from intercourse prior to IUI. Sperm counts vary in men and the frequency of ejaculation does not reflect upon sperm numbers. A semen sample will be collected through ejaculation at the doctor's office about one hour before the intrauterine insemination is scheduled with the woman, allowing time for the sperm to liquefy and time for preparation for the IUI. Preparation includes the washing of the sperm prior to being placed in the woman's uterus. This allows for a better chance for the sperm's survival and for fertilization to take place when the timing is right for IUI.
Ejaculate is made up of two parts, seminal fluid and sperm. Seminal fluid contains a variety of hormones and chemicals, one group of which can be very problematic for fertilization. Prostaglandins, which are responsible for many different functions within the body, can make a woman very sick if they are placed directly into the uterus. If seminal fluid is injected at the time of the IUI, a woman may experience nausea, vomiting, cramping, fever and diarrhea. These symptoms often begin within minutes of performing the IUI.
Washing The Sperm
In order to separate the sperm from the seminal fluid, a process called sperm washing is done. This process not only protects the woman from the problems associated with prostaglandins, it also increases the chances of becoming pregnant. The most basic way of sperm washing is to dilute the semen in a test tube with a special solution of protein supplements and antibiotics. Afterward it is placed in a centrifuge which spins it at very high speeds which separates the sperm from the liquid. The sperm falls to the bottom of the test tube and are then removed and used in the IUI. The entire process takes between 20 and 40 minutes.
One of the more popular sperm washes is the density gradient method which not only washes the sperm but also separates dead sperm cells, white blood cells and other waste products from the sperm. Liquids of varying densities are placed into a test tube and then the sperm is placed on top. The tube is put into a centrifuge where it is spun and the healthy sperm make their way to the very bottom of the test tube. The top layers are siphoned off and the remaining layer of liquid which contains the healthy, live sperm is used in the IUI. The process takes about 60 minutes to complete.
The method which is gaining great popularity in American fertility clinics is the swim up technique which uses the basic understanding that the sperm need to swim up and forward to get to the uterus. Only the most powerful sperm are able to make the swim. To separate the strongest sperm, semen is placed in a culture dish with a layer of media culture. They are attracted to the culture and will swim up to it. The sperm that swim up to it are collected and used in the IUI. This particular technique takes up to two hours to complete.