In vitro fertilization (IVF) requires the retrieval of sperm to fertilize the eggs. It’s important to note that the sperm retrieval method is selected based on the individual’s infertility issues, and it’s recommended to consult with a fertility specialist to determine the best approach.
It is crucial that patients follow the clinical recommendations for semen collection in order to acquire sperm of the highest quality. Be aware that sperm collecting procedures for in vitro fertilization and intrauterine insemination may vary between clinics.
What is semen?
Semen is a substance that is expelled from a male’s penis during ejaculation. It contains sperm, which are male reproductive cells with a unique structure consisting of a head that holds genetic material and a tail that allows it to move toward the egg for fertilization.
Additionally, semen includes fluids to help place the sperm near the back of the female’s vagina close to the cervix, as well as proteins, vitamins, and minerals to support the sperm’s journey. (1)
What is semen analysis?
A lab test called a semen analysis involves examining a sample of semen under a microscope. It evaluates characteristics like sperm quantity, activity (motility), and shape (morphology).
Semen analysis may be necessary for several reasons, including:
- Male Infertility: When a couple has trouble conceiving, a semen analysis is performed to determine if the issue is related to sperm abnormality in the male partner. The analysis helps evaluate the chances of the man causing a pregnancy.
- Vasectomy Check-Up: After a vasectomy procedure, a semen analysis is performed to confirm its success. The procedure blocks the tubes that release sperm into semen. If no sperm is found in the semen, it means the vasectomy was successful and the man is unable to cause a pregnancy. (2)
What are the instructions for semen analysis?
In preparation for a semen analysis, it is important to abstain from sexual activity that results in ejaculation for 2 to 5 days prior. The semen sample must be collected in a designated plastic container provided by the laboratory and should not be collected in any other type of container. It is preferred that the sample is collected in the office, but private rooms are provided for this purpose.
Before collecting the sample, it is important to wash and dry your hands, as well as follow any additional instructions provided by the clinic, such as cleansing the penis. If there are any difficulties in collecting the sample, it is important to notify your physician, who may provide alternative methods such as using a special condom or vibrator.
It is important not to use lubricants unless instructed by a doctor. When labeling and transporting the sample, it is critical to follow the instructions provided by the clinic and to keep the container tightly closed to prevent leakage. If any of the specimens are lost or spilled, or if you have been taking any medications or herbal remedies, it is important to inform the laboratory. (3)
What do the results of a male fertility test look like?
The lab will analyze your sperm based on established standards. Your results should show:
- Active sperm, each with a single round head and tail.
- A certain number of sperm.
- Have a pH that’s not too acidic.
- The fluid turns into liquid in a short amount of time so it can travel through a woman’s reproductive system. (4)
What is the best time for a sperm test?
For accurate semen analysis, it is important to perform the test after a period of sexual abstinence of 3-5 days. Longer abstinence can result in an increase in spermatozoa count but a decrease in motility, vitality, and increased risk of DNA damage, while shorter abstinence can lead to a decrease in spermatozoa count and an increase in motility, resulting in misleading analysis results. Therefore, it is important to adhere to the recommended period of sexual abstinence to obtain accurate and reliable results from the sperm test.
Various factors such as smoking, alcohol consumption, heat, medications, and infections can affect sperm production. If an abnormality is detected in the sperm analysis, physical and hormonal examinations are conducted, and additional samples are taken and evaluated after 3-4 weeks. The production of spermatozoa in the male testes takes around 2-3 months, and hence any damage caused by long-term exposure to toxic substances, abnormal conditions affecting sperm production, and the effects of drugs taken during infertility treatment can only be observed after 2-3 months. This is to be taken into consideration during semen evaluation. If an abnormality is detected in the sperm test, further tests and examinations may be required to determine the cause and appropriate treatment.
Sperm retrieval methods for IVF
Initially, one might consider a self-generated sample as the primary method. In the comfort of a private space at the fertility clinic, the individual tasked with providing the sample does so through masturbation. To enhance the quality of the sperm, it is often suggested that the person maintain a period of abstinence ranging from two to five days before the collection. However, there exist circumstances where this approach is not viable due to factors such as a low sperm count or blockages that prevent natural ejaculation.
In such instances, medical intervention becomes necessary, employing surgical techniques to retrieve sperm directly from the testicular tissue. The procedures are as follows:
- Testicular Sperm Aspiration (TESA): This method involves the use of a needle to aspirate sperm directly from the testes.
- Testicular Sperm Extraction (TESE): Here, a minor incision is made, allowing for the direct extraction of sperm-containing tissue.
Both procedures are minimally invasive and tailored to overcome specific challenges in sperm retrieval, thus providing alternative pathways to achieving conception through IVF. These surgical methods underscore the medical community’s commitment to assisting couples in overcoming infertility challenges.
Source:
1,2,4-https://my.clevelandclinic.org/health/diagnostics/21520-semen-analysis
Vasan, S. S. (2011). Semen analysis and sperm function tests: How much to test?. Indian journal of urology: IJU: journal of the Urological Society of India, 27(1), 41.
