Andrology Services

Andrology is the medical specialty that focuses on the male reproductive system and urological problems that are unique to men. 

The Andrology Laboratory at Manhattan CryoBank specializes in male fertility tests and sperm preparation for artificial insemination. This section provides a high-level overview of the services we provide and the various techniques we use for sperm washing.

Semen Analysis

The purpose of a semen analysis is to measure the volume of semen produced by a man and to determine the quality and quantity of sperm in the semen sample. A semen analysis is usually one of the first tests done to help determine whether a man will experience difficulty fathering a child (infertility).

In a semen analysis, the sample is analyzed for volume, viscosity (thickness), pH and color of the ejaculate, sperm concentration, motility, morphology, and forward progression of the sperm. The sample is also examined for the presence of white or red blood cells that may indicate infection or inflammation.

High-Speed Centrifugation

If, after examining the semen sample, no sperm is observed, the sperm count may still be higher than zero, as there may be very low numbers of sperm in the ejaculate. In these instances, the sperm count must be assessed by high-speed centrifugation of the seminal fluid. The resulting pellet is examined for any sperm under the microscope.

Kruger Morphology

Kruger morphology is a detailed evaluation of the shape of the sperm. The sperm is stained with a special stain and examined microscopically under high power magnification. The sperm must meet a stringent set of criteria that evaluates the shape and size of the head, mid-piece, and tail in order to be considered normal.

Post-Ejaculation Urinalysis

Post-ejaculatory urinalysis is a diagnostic test to determine if the patient suffers from retrograde ejaculation, which is when semen enters the bladder instead of the penis following emission.

Sperm Washing Techniques

Sperm washing is required prior to intrauterine insemination (IUI), because it removes chemicals that may cause adverse reactions in the uterus. Sperm washing also enhances the fertilizing capacity of the sperm and is thus recommended in cases of immunologic, male-factor or unexplained infertility. Sperm washing involves removing the seminal plasma and any cryoprotectant, if used, from the specimen prior to intrauterine insemination. Allergies to antibiotics should be reported prior to washing. The most common techniques for sperm wash are outlined below.

Basic Sperm Wash

This technique uses dilution and centrifugation. In this technique, a sperm wash solution containing protein supplements is added to the ejaculate. After repeated centrifugation, the seminal fluid is eliminated from the sample and the sperm cells are concentrated for insemination. This procedure takes 20 to 40 minutes.

Gradient Wash

This method uses density gradient centrifugation to isolate and purify the motile sperm in order to obtain a sperm sample with a motility of at least 90% (depending on the initial quality of the sample). Different concentrations of gradient are layered in a test tube in an ascending order of density (heaviest layer at the bottom). When a semen sample is placed upon the upper-most gradient layer and centrifuged, any debris, round cells, clumps, non-motile and poor quality sperm remain in the top layers. The majority of the sperm that are able to get through to the bottom layer are motile sperm that are then concentrated for use in artificial insemination. This procedure takes 1 hour.

The Gradient technique is excellent for any type of sample (fresh or frozen) and can help assess male factor fertility.

Swim-Up Technique

This technique uses sperm self-migration to obtain a sperm sample with a motility of at least 90% (depending on the initial quality of the sample). In this technique, a layer of fresh media is gently added to the semen sample in such a way that most of the motile sperm will swim out of the sample and upward into the added media. These harvested motile sperm are subsequently used for insemination. This procedure takes 2 hours.

Men with oligozoospermic (low sperm counts), sperm with poor motility, as well as male-factor infertility are not suitable candidates for this technique. Their sperm will have difficulty swimming up out of the pellet into the nutrient medium.

All of the above washing techniques can be performed on a single specimen prior to initiating intrauterine insemination therapy. This trial wash helps determine the sperm washing technique that will yield the best results.