1. Best sperm preparation technique in IUI
Novita Prasetiawati
Senior Embryologist Melati Clinic RSAB Harapan Kita

2. Introduction
Semen contains of: Sperm + Seminal plasma Should it be separated ?? - Diagnostic test - Therapeutic recovery (IUI and ART)

3. Before Treatment Cycle
1x semen analysis
Preparation must be with in 1 hour after ejaculation

4. Sperm Separation Aims to:
Eliminates seminal plasma, debris and contaminants
Concentrate progressively motile sperm
Select morphologically normal sperm

5. Semen Analysis (WHO 2010) Volume (≥1,5 ml) Morphology ≥ 4%
Concentration ≥ 15x106 /ml
Σ Motile Sperm ≥ 39x106/ ml
Morphology ≥ 4%

6. Sperm preparation Method
Simple Washing
Direct Swim Up
Density Gradien

7. Incubator Incubator Non CO2 Incubator CO2
the medium must be added buffer with hepes or similar
Caps tubes tightly closed
Incubator Non CO2
Medium buffered with sodium bicarbonate
Caps tubes should be loosed to allow gas exchange
Incubator CO2

8. Simple Washing Centrifugation Diluting semen + Medium culture
High yield sperm, but debris & cells including in pellet

9. Swim Up Technique Sperm swim up to medium Normozoospermia
Clean but < sperm yield (<20%)
> zinc concentration
IVF & ICSI

10. Discontinuous Density-gradients
Best selection of good-quality spermatozoa (>20%)
Good separation from other cell & debris
Easier
Used for IUI, IVF & ICSI

11. Normozoospermia VS OAT in 2016-2017

12. Gradien vs Swim up in

13. Pregnancy rates of IUI base on Sperm count (ASRM 2015)

14. Conclusion
For treatment cycle (TC) sperm must be separate from seminal plasma
Semen Analysis must be performed at least once before TC
Semen analysis should be performed according WHO 2010
Density Gradien gives more advantages than other techniques

15. Terima kasih