METHODS OF SEMEN PREPARATION FOR INTRAUTERINE INSEMINATION AND SUBSEQUENT PREGNANCY RATES

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.