Pm. Zavos et Gm. Centola, METHODS OF SEMEN PREPARATION FOR INTRAUTERINE INSEMINATION AND SUBSEQUENT PREGNANCY RATES, Tohoku Journal of Experimental Medicine, 168(4), 1992, pp. 583-590
Semen for insemination, either intrauterine or in vitro, must be prepa
red to remove seminal plasma products and/or select the healthier popu
lation of sperm prior to use. Traditionally, a double wash technique i
s performed, with or without subsequent swim-up to isolate the motile
fraction if necessary. More recently, the use of the SpermPrep filtrat
ion method has gained acceptance, with the benefits of removal of leuk
ocytes and seminal debris from the specimen as well as enhancement of
overall sperm quality. In the current study we compared the traditiona
l double wash method without the swim-up to SpermPrep filtration. Intr
auterine inseminations (IUI's) were performed in 307 cycles on 148 inf
ertile couples at two different infertility centers, in the USA. After
complete diagnostic evaluation the couples were offered IUI before pr
oceeding to any other form of assisted reproductive technologies. Seme
n samples were prepared in human tubal fluid media supplemented with 5
% human serum albumin (HSA; location 1) or in Ham's F-10 media supplem
ented with 3% HSA (location 2), either with the SpermPrep filtration m
ethod (ZBL, Inc., Lexington, KY 40523, USA) or the double sperm wash (
SW) procedure. Similar sperm numbers were used for the IUI procedure i
n both treatment groups and locations. The SpermPrep method resulted i
n significantly higher pregnancy rates (PR) than the SW procedure, ind
ependent of location. The clinical pregnancy rates per cycle were stat
istically lower (p < 0.05) in the SW group (20-22% vs. 9-10%). Of sign
ificant clinical importance, almost twice as many cycles were required
in the SW group to achieve these pregnancies when compared to the Spe
rmPrep group of patients. The results point out that IUI has a signifi
cant role to play in the treatment of many infertile couples. Furtherm
ore, the results point out very clearly that selecting high quality sp
ermatozoa via the SpermPrep method resulted in even higher conception
rates than the SW method when IUI was applied. Similar improvements in
PR using the SpermPrep method may be realized with other artificial r
eproductive techniques.