Sperm washing

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Sperm washing is the process in which individual sperms are separated from the semen. Washed sperm is used in artificial insemination using the intrauterine insemination (IUI) technique and in in vitro fertilization (IVF). It may also be used to decrease the risk of HIV transmission by an HIV-positive male, in which case the washed sperm is injected into a female using an artificial insemination technique.

Contents

Sperm washing involves removing any mucus and non-motile sperm in the semen to improve the chances of fertilization and to extract certain disease-carrying material in the semen. Sperm washing is a standard procedure in infertility treatment.

Once the fastest sperm have been isolated, before using them for artificial insemination or in vitro fertilization, it is important to confirm the absence of HIV virus in the sample.

The sample obtained after washing is analysed, usually using the PCR technique, to check that there is no viral particle. If the result is negative, i.e. there is no virus, this sample is suitable for use in assisted reproduction treatments.

These samples are usually free of the virus in a high percentage. [1]

Procedure

Sperm washing takes place in a laboratory following sperm donation.

Sperm may be washed by density gradient centrifugation or by a "direct swim-up" technique that does not involve centrifugation. In normal semen samples, centrifugation causes no more DNA damage to spermatozoa than a direct swim-up technique. [2]

Washed sperm is concentrated in Ham's F-10 media without L-glutamine, warmed to 37 °C (99 °F). [3] A chemical known as a cryoprotectant is added to the sperm to aid the freezing and thawing process. [4] Further chemicals may be added which separate the most active sperm in the sample, as well as extend or dilute the sample so that vials for a number of inseminations are produced.

Decreased HIV transmission

Sperm washing can be used to decrease the risk of HIV transmission in HIV-positive males, because the infection is carried by the seminal fluid rather than the sperm. One Italian study from 2005 of 567 serodiscordant couples treated with washed sperm resulted in no horizontal (to the woman) or vertical (to the child) HIV seroconversion. [5] However, there is no 100% guarantee that washed sperm is free from the virus. [5]

History

Sperm washing was first used in Milan, Italy. The oldest child conceived using this method was born in 1997 and is HIV negative. The first known baby conceived this way in the United States, Baby Ryan, was born in 1999 [6] through the Special Program of Assisted Reproduction started by Ann Kiessling.

Starting in the mid-1990s the technique was used to help HIV discordant couples conceive without passing the virus from the father to the mother or child. [7] The idea is that when the male is HIV positive, the technique will reduce the risk of transmission to the female. For years there were lingering doubts about the safety of the procedure, and many couples had to travel to places that would do the procedure, such as Italy. Today, hundreds of babies have been born through this process.

Related Research Articles

<span class="mw-page-title-main">In vitro fertilisation</span> Assisted reproductive technology procedure

In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm in vitro. The process involves monitoring and stimulating a woman's ovulatory process, removing an ovum or ova from their ovaries and letting a man's sperm fertilise them in a culture medium in a laboratory. After the fertilised egg (zygote) undergoes embryo culture for 2–6 days, it is transferred by catheter into the uterus, with the intention of establishing a successful pregnancy.

<span class="mw-page-title-main">Intracytoplasmic sperm injection</span> In vitro fertilization procedure

Intracytoplasmic sperm injection is an in vitro fertilization (IVF) procedure in which a single sperm cell is injected directly into the cytoplasm of an egg. This technique is used in order to prepare the gametes for the obtention of embryos that may be transferred to a maternal uterus. With this method, the acrosome reaction is skipped.

<span class="mw-page-title-main">Artificial insemination</span> Pregnancy through in vivo fertilization

Artificial insemination is the deliberate introduction of sperm into a female's cervix or uterine cavity for the purpose of achieving a pregnancy through in vivo fertilization by means other than sexual intercourse. It is a fertility treatment for humans, and is a common practice in animal breeding, including dairy cattle and pigs.

Insemination is the introduction of sperm (semen) into a female or hermaphrodite's reproductive system in order to fertilize the ovum through sexual reproduction. The sperm enters into the uterus of a mammal or the oviduct of an oviparous (egg-laying) animal. Female humans and other mammals are inseminated during sexual intercourse or copulation, but can also be inseminated by artificial insemination.

Capacitation is the penultimate step in the maturation of mammalian spermatozoa and is required to render them competent to fertilize an oocyte. This step is a biochemical event; the sperm move normally and look mature prior to capacitation. In vivo, capacitation occurs after ejaculation, when the spermatozoa leave the vagina and enter the upper female reproductive tract. The uterus aids in the steps of capacitation by secreting sterol-binding albumin, lipoproteins, and proteolytic and glycosidasic enzymes such as heparin.

<span class="mw-page-title-main">Assisted reproductive technology</span> Methods to achieve pregnancy by artificial or partially artificial means

Assisted reproductive technology (ART) includes medical procedures used primarily to address infertility. This subject involves procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), cryopreservation of gametes or embryos, and/or the use of fertility medication. When used to address infertility, ART may also be referred to as fertility treatment. ART mainly belongs to the field of reproductive endocrinology and infertility. Some forms of ART may be used with regard to fertile couples for genetic purpose. ART may also be used in surrogacy arrangements, although not all surrogacy arrangements involve ART. The existence of sterility will not always require ART to be the first option to consider, as there are occasions when its cause is a mild disorder that can be solved with more conventional treatments or with behaviors based on promoting health and reproductive habits.

<span class="mw-page-title-main">Embryo transfer</span> Method of assisted reproduction

Embryo transfer refers to a step in the process of assisted reproduction in which embryos are placed into the uterus of a female with the intent to establish a pregnancy. This technique - which is often used in connection with in vitro fertilization (IVF) - may be used in humans or in other animals, in which situations and goals may vary.

<span class="mw-page-title-main">Sperm bank</span> Facility that allocates human semen

A sperm bank, semen bank, or cryobank is a facility or enterprise which purchases, stores and sells human semen. The semen is produced and sold by men who are known as sperm donors. The sperm is purchased by or for other persons for the purpose of achieving a pregnancy or pregnancies other than by a sexual partner. Sperm sold by a sperm donor is known as donor sperm.

<span class="mw-page-title-main">Fertility clinic</span>

Fertility clinics are medical clinics that assist couples, and sometimes individuals, who want to become parents but for medical reasons have been unable to achieve this goal via the natural course. Clinics apply a number of diagnosis tests and sometimes very advanced medical treatments to achieve conceptions and pregnancies.

The Special Program of Assisted Reproduction (SPAR) is a program offered to HIV discordant couples (serodiscordant) at the Bedford Research Foundation's clinical laboratory. The program takes advantage of ART procedures to assist couples achieve a pregnancy who would otherwise risk transmitting the father's HIV infection to the mother and the child through intercourse.

<span class="mw-page-title-main">Oocyte cryopreservation</span> Procedure to preserve a womans eggs (oocytes)

Oocyte cryopreservation is a procedure to preserve a woman's eggs (oocytes). This technique has been used to postpone pregnancy. When pregnancy is desired, the eggs can be thawed, fertilized, and transferred to the uterus as embryos. Several studies have shown that most infertility problems are due to germ cell deterioration related to aging. The procedure's success rate varies depending on the age of the woman,, as well as depending on health and genetic indicators. In 1986, the first human birth of oocyte cryopreservation was reported.

<span class="mw-page-title-main">Bedford Research Foundation</span>

Bedford Research Foundation is a non-profit Institute that conducts stem cell research for diseases and conditions that currently have no known cure. The institute also created the Special Program of Assisted Reproduction (SPAR), a program that assists serodiscordant couples successfully achieve pregnancy. Dr. Ann Kiessling, the founder of Bedford Stem Cell Research Foundation, is the Laboratory Director.

Sperm sorting is a means of choosing what type of sperm cell is to fertilize the egg cell. Several conventional techniques of centrifugation or swim-up. Newly applied methods such as flow cytometry expand the possibilities of sperm sorting and new techniques of sperm sorting are being developed.

A conception device is a medical device which is used to assist in the achievement of a pregnancy, often, but not always, by means other than sexual intercourse. This article deals exclusively with conception devices for human reproduction.

Sperm donation is the provision by a man of his sperm with the intention that it be used in the artificial insemination or other "fertility treatment" of one or more women who are not his sexual partners in order that they may become pregnant by him. Where pregnancies go to full term, the sperm donor will be the biological father of every baby born from his donations. The man is known as a sperm donor and the sperm he provides is known as "donor sperm" because the intention is that the man will give up all legal rights to any child produced from his sperm, and will not be the legal father. Sperm donation may also be to known as "semen donation".

Semen extender is a liquid diluent which is added to semen to preserve its fertilizing ability. It acts as a buffer to protect sperm cells from their own toxic byproducts, as well as protecting the sperm from cold shock and osmotic shock during the chilling and shipping process. The extender allows the semen to be shipped to the female, rather than requiring the male and female to be near to each other. Special freezing extender use also allows cryogenic preservation of sperm, which may be transported for use, or used on-site at a later date.

Religious response to assisted reproductive technology deals with the new challenges for traditional social and religious communities raised by modern assisted reproductive technology. Because many religious communities have strong opinions and religious legislation regarding marriage, sex and reproduction, modern fertility technology has forced religions to respond.

Semen cryopreservation is a procedure to preserve sperm cells. Semen can be used successfully indefinitely after cryopreservation. It can be used for sperm donation where the recipient wants the treatment in a different time or place, or as a means of preserving fertility for men undergoing vasectomy or treatments that may compromise their fertility, such as chemotherapy, radiation therapy or surgery. It is also often used by trans women prior to medically transitioning in ways that affect fertility, such as feminizing hormone therapy and orchiectomies.

In sperm banks, screening of potential sperm donors typically includes screening for genetic diseases, chromosomal abnormalities and sexually transmitted infections (STDs) that may be transmitted through the donor's sperm. The screening process generally also includes a quarantine period, during which samples are frozen and stored for at least six months after which the donor will be re-tested for STIs. This is to ensure no new infections have been acquired or have developed during since the donation. If the result is negative, the sperm samples can be released from quarantine and used in treatments.

<span class="mw-page-title-main">Use of assisted reproductive technology by LGBT people</span>

Lesbian, gay, bisexual, and transgender people people wishing to have children may use assisted reproductive technology. In recent decades, developmental biologists have been researching and developing techniques to facilitate same-sex reproduction.

References

  1. Zamora, Maria Jose; Obradors, Albert; Woodward, Bryan; Vernaeve, Valerie; Vassena, Rita (June 2016). "Semen residual viral load and reproductive outcomes in HIV-infected men undergoing ICSI after extended semen preparation". Reproductive Biomedicine Online. 32 (6): 584–590. doi: 10.1016/j.rbmo.2016.02.014 . ISSN   1472-6491. PMID   26995657.
  2. Younglai EV, Holt D, Brown P, Jurisicova A, Casper RF (September 2001). "Sperm swim-up techniques and DNA fragmentation". Hum. Reprod. 16 (9): 1950–3. doi: 10.1093/humrep/16.9.1950 . PMID   11527903.
  3. Adams, Robert, M.D."invitro fertilization technique", Monterey, CA, 1988
  4. Imrat, P.; Suthanmapinanth, P.; Saikhun, K.; Mahasawangkul, S.; Sostaric, E.; Sombutputorn, P.; Jansittiwate, S.; Thongtip, N.; Pinyopummin, A.; Colenbrander, B.; Holt, W.V.; Stout, T.A.E. (February 2013). "Effect of pre-freeze semen quality, extender and cryoprotectant on the post-thaw quality of Asian elephant (Elephas maximus indicus) semen". Cryobiology. 66 (1): 52–59. doi:10.1016/j.cryobiol.2012.11.003. hdl: 2263/42468 . PMID   23168056.
  5. 1 2 About.com > HIV and Sperm Washing. Archived 2009-04-03 at the Wayback Machine By Mark Cichocki, R.N. Updated December 18, 2009
  6. "Conceiving Ryan". American Radio Works.
  7. "Sperm Washing: How it Works". American Radio Works.