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Sperm Washing

If you are having difficulties becoming pregnant, you may have decided to try certain fertility treatments in order to increase your chances of conceiving. Intrauterine insemination (IUI) is often the first type of fertility treatment attempted by couples. In order to get sperm ready for the IUI procedure, it must first be washed. Sperm washing may sound strange, but it actually works to ensure that only the healthiest sperm are used during the procedure. Sperm washing can increase your chances of conception and may help you to welcome a new addition to your family. Sperm washing is a procedure used to prepare sperm for use in IUI. It allows your partner’s sperm a better chance for survival and fertilization. Sperm washing separates sperm cells from a man’s semen, helping to get rid of dead or slow-moving sperm as well as additional chemicals that may impair fertilization. Once sperm has been washed at your fertility clinic’s laboratory, it can be used during IUI to help achieve pregnancy. There are a variety of different sperm washing procedures.

Sperm must be washed in order to be used with IUI. Raw semen cannot be inserted directly into a woman’s uterus. This is because semen contains chemicals called prostaglandins. Prostaglandins cause muscular contractions and are responsible for cramps during menstruation and pregnancy. If raw semen is inserted directly into your uterus, rather than going through the cervix first, it could cause severe pain and cramping. It could also cause your uterus to collapse, causing severe complications.
Sperm is also washed in order to increase your chances of becoming pregnant. Sperm washing can remove dead sperm and those sperm with poor motility. This leaves behind sperm that can swim faster and that are more likely to fertilize your egg. Sperm washing can also get rid of the white blood cells, mucous and seminal fluid surrounding the sperm, which can also interfere with fertility.

Anyone who pursues IUI will receive the sperm washing procedure. However, the procedure can also benefit others, especially those with:

-unexplained infertility
-male-factor infertility
-women with endometriosis
-men with antisperm antibodies


The sperm wash procedure is actually relatively easy to prepare for. Your semen will be collected after you masturbate, or from a sample taken during surgical sperm retrieval. It is important to refrain from sexual intercourse for two days before your sperm is collected. However, do not go more than five days without intercourse. Certain antibiotics may also affect the quality of your sperm, so speak with your fertility physician if you are taking any medications.

There are three commonly-used sperm washing techniques:

Simple Sperm Wash
The simple sperm wash technique is the most basic way of washing and preparing sperm for IUI. Semen is diluted in a test tube with a special solution of antibiotics and protein supplements. It is then placed in a centrifuge, a machine that spins around at extremely high speeds. As the sperm mixture is spun, sperm cells fall to the bottom of the test tube, producing a mass of dense, highly active sperm. These sperm can then be removed from the test tube and used in IUI. A simple sperm wash takes about 20 to 40 minutes.

Density Gradient Sperm Wash
The density gradient sperm wash is one of the most popular sperm washing methods. This is because it also works to separate dead sperm cells, white blood cells, and other waste products from the sperm. A test tube is filled with multiple layers of liquids of different densities. Semen is then placed on the top layer of liquid and the test tube is spun in a centrifuge. After it is spun, active, healthy sperm will make their way to the very bottom layer of liquid in the test tube, while debris and dead sperm will get caught in the top two layers. These layers can be siphoned off in order to remove the active sperm from the test tube. This sperm is then used in the IUI procedure. Density gradient sperm washes take approximately 60 minutes.

Swim Up Technique
The swim up technique is rapidly becoming more and more popular throughout Indian fertility clinics. This technique revolves around the fact that sperm need to swim forwards and up in order to reach the uterus. Only the most powerful sperm will be able to do this. In order to retrieve this powerful sperm, semen is placed in a culture dish with a layer of media culture. Sperm are attracted to this culture, and will swim up to it. As the sperm swim up to the culture, they are collected. This technique takes about an hour in order to harvest enough sperm for use in IUI.

Success Rates
Success rates do increase when sperm washing is used with IUI. Because sperm washing ensures that only the most healthy and active sperm are used for fertilization, there is an increased chance that you will become pregnant when using washed sperm. However, success rates do depend on your partner’s overall sperm count. Typically, the lowest sperm count to be used with sperm washing is one million, however, success rates are significantly lower if your sperm count falls beneath five to ten million. The best sperm counts for use with sperm washing are those between 20 and 30 million.

Cost of the Procedure
The cost of sperm washing in itself is relatively low. A basic sperm wash typically costs only Rs.3000 or so. If you opt for one of the more advanced forms of sperm washing, it could cost you up to Rs.10000. However, sperm washing is only of use when combined with other fertility treatment procedures. One session of natural IUI typically costs under Rs.3000 while IUI with the use of fertility drugs and monitoring can cost anywhere between Rs 8000 and Rs 10,000.

Egg Quality

A common cause of infertility in women is poor egg quality. Poor egg quality does not have to be the end of your chances for pregnancy – a variety of unique fertility treatments are available to help you achieve your pregnancy. All women have a finite number of eggs in their body which, when released during ovulation, can be fertilized to produce a child. Most people believe that all that matters when you are trying to get pregnant is the number of eggs you have – as long as you have a lot of eggs, you’ll get pregnant. Unfortunately, this is not the case. True, the number of eggs that you have does matter, but so does the quality of those eggs. Together, the number and quality of your eggs are referred to as your ovarian reserve. Egg quality refers to how prepared your eggs are to develop into embryos once they are fertilized. In order to be healthy enough to develop, an egg needs to have the proper chromosomes and the ability to combine those chromosomes with sperm. Some eggs in your body just don’t have the right number of chromosomes, making it impossible to have a successful pregnancy.

The eggs in your ovaries also need energy in order to split after fertilization. Your eggs contain mitochondria, which are tiny cell organelles that provide the energy for the egg. Without mitochondria, your egg wouldn’t have the energy to survive. As you age, these mitochondria produce less and less energy. As a result, any egg that is fertilized will eventually run out of energy and will be unable to divide.

Egg quality is greatly affected by your age. In your 20s and early 30s, you should have a large number of good quality eggs available for fertilization. Yes, you will have a few bad eggs too, but the good ones should vastly outweigh them. However, as you age your eggs will begin to decline in quality as well as in number. By the time you are in your late 30s or early 40s, you will probably have more poor quality eggs available than good quality eggs.

However, you don’t have to be over the age of 40 to have poor quality eggs. Some younger women can also have a poor ovarian reserve, either as a result of health problems or genetics. In particular, smoking, radiation therapy, and chemotherapy have been known to cause eggs to decline in health. If you suffer from endometriosis, you may also find that your egg quality is poorer than you would like it to be.

Egg quality has a huge impact on your fertility. If you have poor quality eggs, you will probably have a difficult time getting pregnant and staying pregnant. The impact of poor quality eggs is reflected in the general decline in pregnancy rates as women age. Women between the ages of 15 and 25 have a 40% chance of conceiving every cycle. Women who are over 40 however, have less than a 25% chance of becoming pregnant naturally. This is due to the fact that women who are older tend to have fewer eggs and eggs of a poorer quality. Poorer quality eggs can be one of the major causes of infertility in a number of ways. Firstly, poor quality eggs can make conceiving a child very difficult. If a baby is conceived, a poor quality egg can make the difference between carrying your baby to term or losing it in the first few weeks. Many poor quality eggs do not implant properly into the uterus once they are fertilized. Others implant properly but are simply not healthy enough to grow and divide, resulting in a miscarriage.

If you think you may be struggling with fertility issues, it is important to get checked out by a health care professional. In particular, you should probably make sure that your eggs are healthy and of a good quality. Women who are struggling with infertility and are over the age of 37 are usually tested for this.t is difficult to determine the quality of an egg simply by looking at it. Doctors usually have to implant the egg using in vitro fertilization to see whether it will grow or not. However, there is fertility testing to determine if you may be suffering from poor egg quality. Typical tests that evaluate your egg equality include:
Day 2/ 3 FSH Test: Measures your levels of FSH. Elevated levels may indicate poor egg quality.
Clomid Challenge Test (CCCT): The clomid challenge test is a blood test.

If you are suffering from poor egg quality there are a variety of fertility treatments that you can pursue to help you to conceive. Just because you have poor quality eggs does not mean that it is impossible for you to become pregnant. Using fertility drugs is one way to possibly increase the quantity and quality of your eggs. Typical female infertility drugs include clomiphene and cabergoline. In vitro fertilization is another treatment option. However, if your eggs are of too poor quality, you may be encouraged to use an egg donor.

Research into improving egg quality is ongoing. One treatment currently in the trial phase is cytoplasmic transfer. This form of treatment involves putting cytoplasm (the watery, outside layer of a cell) from a healthy donated egg into a poor quality egg in order to help it divide. Nuclear transfer is another form of treatment currently under investigation. Nuclear transfer involves taking a healthy nucleus from a donated egg and transferring it into an egg with an unhealthy nucleus. This helps to improve the quality of the egg thereby increasing the chances of conception occurring. Though neither of these procedures are currently available to the general public, there is hope that they may come to fertility clinics in the near future.

Role of the mitochondrial genome in assisted reproductive technologies

Mitochondria play a pivotal role in cellular metabolism and are important determinants of embryonic development. Mitochondrial function and biogenesis rely on an intricate coordination of regulation and expression of nuclear and mitochondrial genes. For example, several nucleus-derived transcription factors, such as mitochondrial transcription factor A, are required for mitochondrial DNA replication. Mitochondrial inheritance is strictly maternal while paternally-derived mitochondria are selectively eliminated during early embryonic cell divisions. However, there are reports from animals as well as human patients that paternal mitochondria can occasionally escape elimination, which in some cases has led to severe pathologies. The resulting existence of different mitochondrial genomes within the same cell has been termed mitochondrial heteroplasmy. The increasing use of invasive techniques in assisted reproduction in humans has raised concerns that one of the outcomes of such techniques is an increase in the incidence of mitochondrial heteroplasmy. Indeed, there is evidence that heteroplasmy is a direct consequence of ooplasm transfer, a technique that was used to 'rescue' oocytes from older women by injecting ooplasm from young oocytes. Mitochondria from donor and recipient were found in varying proportions in resulting children. Heteroplasmy is also a byproduct of nuclear transfer, as has been shown in studies on cloned sheep, cattle and monkeys. As therapeutic cloning will depend on nuclear transfer into oocytes and the subsequent generation of embryonic stem cells from resulting blastocysts, the prospect of mitochondrial heteroplasmy and its potential problems necessitate further studies in this area.

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Rotunda Management Meetings

Hi friends, we are rushing towards another weekend and also on the cusp of getting our fresh re-certification audit done for the ISO 9001-2000 standards for our clinic. Everyone is working hard towards the goal. Just found a nice cartoon in NY times about our management meetings.
Have a nice weekend, folks.