When the decision is made to proceed with IUI, some preparation of the sperm is necessary in order to complete the procedure and help ensure a successful outcome.
A semen sample is collected through ejaculation into a sterile collection cup at the clinic or doctor’s office. If, for some reason the man is unable to provide a sample at the office, then he will collect it at home and bring it into the office within 30 minutes of collection. It is important the sperm be kept warm. The collection takes place an hour before the IUI procedure is performed.
Why The Sperm Is Separated From The Semen
Ejaculate is comprised of two parts, seminal fluid, and sperm. There are many types of hormones and chemicals present in semen that can be problematic for fertilization. Prostaglandins, which are responsible for a wide variety of bodily functions, have the potential to cause serious difficulties. If high levels of prostaglandins are injected directly into a woman’s uterus, the woman can become very ill. She may experience very severe and painful cramping, nausea, vomiting, fever and diarrhea because of prostaglandin absorption during IUI. That is why it is necessary to separate the sperm from the semen prior to IUI.
Sperm Washing, The Basics
The term, sperm washing, is probably a misnomer because the sperm are not actually washed or cleaned. They are separated from the semen through one of several different processes and since there is no “best way,” the decision as to how the sperm is washed is determined by the specialist. Separating the sperm from the semen means that only the healthiest sperm with the highest motility are used in IUI, gaining an edge in the fertilization process.
The most basic way of preparing the sperm for IUI is by diluting the semen in a test tube with a special solution of antibiotics and protein supplements. The tube is placed in a centrifuge where, through the spinning process, sperm fall to the bottom of the test tube. A mass of dense, highly active sperm remains on the bottom of the test tube. They can then be used in the IUI. A simple sperm wash takes between 20 to 40 minutes.
The Density Gradient Method
The density gradient sperm wash not only separates sperm from semen, it also separates dead sperm cells, white blood cells and other waste from the active, healthy sperm. Two layers of liquids of different densities are placed in a test tube with semen placed on the very top. The tube is spun in a centrifuge and the sperm makes its way to the bottom of the test tube. The top layers are siphoned off, leaving the clean, active sperm on the bottom ready to be used in the IUI. This process takes about an hour.
Only The Strong Survive
A technique, which is becoming more popular in fertility clinics, is the swim-up technique. The concept is centered on the idea that the sperm need to swim up and forward in order to get to the uterus. Only the strongest and most powerful sperm are able to accomplish this. To retrieve the strong sperm, semen is placed in a culture dish in a layer of media culture that attracts the sperm. As the sperm swim up to the culture, they are collected and then used in the IUI. Of all procedures, this takes the longest-about two hours.