The last post was about what we embryologists do for a single IVF cycle. In this post, I want to share some of our other responsibilities in the lab focusing on sperm.
In some clinics, andrologists are separate from embryologists and so anything sperm related is dealt with by andrologists. In other labs including the lab I work in embryologists also take on the responsibilities of andrologists. Some of the main tasks include: sperm analysis, sperm freezing, sperm thawing, processing of sperm for IUI and IVF/ICSI, processing of PESA (Percutaneous Epididymal Sperm Aspiration), TESE (Testicular Sperm Aspiration) and MESE (Microsurgical Epididymal Sperm Aspiration) samples, receiving and sending frozen samples. Sometimes these tasks can be tedious especially in cases of low sperm quantity. For example, if a sample has a low sperm count then we may have to try different techniques (gradient, concentration, swim-up) in order to prepare the sample for a procedure. It is also very important to keep track of everything that is going on in the lab. For example, if a patient wants to proceed with an IUI or IVF procedure, their sperm sample has to be checked prior to the procedure. If their sample is borderline, we may have to freeze the sample as a back-up for the procedure.
The World Health Organization (WHO), has specific guidelines on the sperm parameters mentioning what is considered in the normal range. I'll provide a brief overview of this but will include a link to the WHO Laboratory manual for a more detailed explanation for anyone who is interested: https://www.who.int/reproductivehealth/publications/infertility/9789241547789/en/. This manual also includes tips for sperm collection and explains what each parameter means.
The most common parameters are ejaculate volume, sperm concentration, motility (progressive or non-progressive), sperm morphology and any additional comments.
The normal ranges are as follows:
- Volume - between 1 to 7
- concentration - between 15 to 300 million per milliliter
- motility - between 30 to 75% progressive
- morphology - 4 to 48% normal looking sperm
If these parameters are not normal, further investigations will have to be conducted such as hormonal blood tests (FSH, LH, fructose), genetic testing (karyotype and presence of SRY gene), repeat SA in a few months with vitamins given to boost sperm production.
If you have any questions or concerns regarding sperm analysis or other techniques, feel free to contact me.