Presentation on theme: "SEMEN PREPARATION for IUI"— Presentation transcript:
1 SEMEN PREPARATION for IUI Dr Aruna SaxenaMD(Obs& Gynae),ARTCE (NUS, Singapore)Director ,Lifecare IVF Pvt Ltd
2 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.
3 SEMEN COLLECTION AND DELIVERY WHO recommendation 3-5 days of abstinenceMasturbationClean wide mouth sterile containerLabelingFirst portion of ejaculate should not be lostCollection in non spermicidal condom following intercourse
5 Which technique ?GOOD : Parameters normal /> normal BAD : Parameters less than normal UGLY : Parameters severely low, viscous , infected , agglutination NO SPERMS : high speed centrifugation VERY LOW COUNT : Pooling of samples
10 INSTRUCTIONS TO BE FOLLOWED WHILE HANDLING SEMEN SAMPLE Clean sterile work area (Laminar air flow)Non-toxic, non-powdered glovesSlow DilutionPre warm media and disposablesPreparation performed at 37`cThorough identification protocolDamage to the sperm from dilution, temperature change.centrifugation,and exposure to potentially toxic material must be minimised
12 Semen préparation techniques for intrauterine insémination (Review) Boomsma CM, Heineman MJ, Cohlen BJ, Farquhar C The Cochrane Library 2009, Issue 1Five RCTs, including 262 couples in total, were included in the meta-analysisNo 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.
13 Authors’ conclusionsThere 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.