Fertility Tests & Sperm Wash

Our andrology laboratory 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 used 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 number and quality of sperm in the semen sample. A semen analysis is usually one of the first tests done to help determine whether a man has a problem fathering a child (infertility).
Semen analysis is a diagnostic test that provides important information about the quality and quantity of the sperm. The semen 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 not be zero (there may be very low numbers of sperm in the ejaculate). 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.

Fructose
In men with no sperm (azoospermia), the fructose test can help determine whether sperm is not produced at all or if the sperm is produced but blocked from getting into the semen.

Viability
The viability test is a specialized staining technique used to determine the percentage of live sperm. This test is part of the complete semen analysis and is performed when no motile sperm is observed in the ejaculate after high-speed centrifugation.

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-Ejaculatory Urinalysis
Post-ejaculatory urinalysis is a diagnostic test to determine if the patient suffers from retrograde ejaculation (semen enters the bladder instead of the penis following emission).

Anti-Sperm Antibody
Anti-sperm Antibody is a diagnostic test to determine the presence of cells that fight against normal, healthy sperm. In the presence of anti-sperm antibodies, the immune system fights against your sperm and destroys them.

Sperm penetration assay
The sperm penetration assay is a multi-step laboratory test that offers a biological assessment of some aspects of human sperm fertilizing ability. It specifically measures sperm capacitation (the capacity of sperm to undergo the complex membrane changes necessary to fertilize human ova).

Sperm Washing Techniques
Sperm washing is required prior to intrauterine insemination 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. 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 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.

Mini Gradient Wash
Mini gradient wash is a variation of the gradient wash that achieves similar results but may improve overall recovery for those semen specimens of low density and/or low motility.

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. 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. Oligozoospermic men (men with low sperm counts), men with poorly motile sperm as well as men with 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.

Chymotrypsin Wash
This wash procedure may reduce the amount of agglutinated or clumped sperm in the final preparation. It is especially useful for semen samples that appear to have many motile sperm clumped (agglutinated) together.

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.

Please contact our office for further information or to schedule an appointment.