When you think of someone struggling with infertility, chances are that you picture a woman trying to become pregnant, maybe undergoing IVF or other reproductive techniques. However, according to the international infertility organization, Resolve, about 30% of infertility cases are related to male factor issues, and another 20% are attributed to combined male and female factors. While IVF and other fertility treatments are fairly well-known, a technique called sperm washing can help increase the success rate of some assisted fertility treatments, especially when male factor issues are present.
Patients often ask me the purpose of sperm washing and if it really makes a difference. Sperm washing is a process through which healthy sperm is separated from the rest of a semen sample. This is done because in addition to healthy sperm, semen fluid contains other components, such as proteins, enzymes, white blood cells, mucous and dead or non-motile sperm that are not beneficial in mixing with eggs for IVF or intrauterine insemination. In addition, semen contains prostaglandins, which are hormone-like substances that if inserted directly into your uterus could cause severe cramping and pain.
Sperm washing often used for intrauterine insemination, called IUI, in which sperm is directly placed inside a women’s uterus. IUI is often the first line of medical treatments for couples who are undergoing fertility treatments. It’s also used for male factor infertility, in cases where the woman has endometriosis, and to improve chances of fertilization with induced ovulation. Preparing the sperm by sperm washing ensures that only the viable sperm are used that are most likely to fertilize an egg.
In addition to IUI, sperm washing is also widely used prior to sperm freezing and prior to IVF fertilization using a method called ICSI. Also called intracytoplasmic sperm injection, ICSI is a microscopic technique in which a single sperm is injected directly into a mature egg. ICSI is helpful in cases of low sperm count or the quality of the sperm is less than ideal. For couples in which male factor is contributing to infertility, ICSI can improve insemination rates equal to that of traditional IVF where there isn’t a male factor issue.
You may be thinking, how exactly does one wash sperm? Sperm washing takes place in a lab after semen is collected. There a few different techniques, including:
- Simple sperm wash, which like its name is pretty basic. The semen is mixed in a test tube with a solution containing protein supplements and antibiotics, and then placed in a centrifuge which spins the sperm at a high speed. This causes the sperm cells to fall to the bottom, which results in a high concentration of motile sperm, which are removed and used for IUI, IVF or ICSI.
- Density gradient wash is a technique in which a test tube is filled with a concentration of dense media. The semen is placed on top and like the simple sperm wash, the test tube is spun in a centrifuge, which causes the healthiest sperm to collect in the bottom of the concentration. Unwanted components, such as dead sperm will become trapped at the top and removed. This technique yields a good sample of highly concentrated viable sperm.
- Swim up technique uses a conical tube, and the semen sample is centrifuged into a pellet shape. A layer of media is then place over the pellet and allowed to rest. After an hour, the top layer of the media is removed and the active sperm that have swum to the top are collected. The reasoning behind this technique is that only the most active sperm that are able to swim to the top are the healthiest and most viable.
Fertility success rates using sperm washing techniques depend on a number of factors, including sperm count, motility and overall quality. That said, the rate of successful pregnancies increases when sperm washing is involved because regardless of technique used, sperm washing translates into IUI, IVF or other assisted reproductive techniques that are using the most active and viable sperm for fertilization.
In order to further enhance sperm quality, some males also add acupuncture to their fertility protocol. While many fertility doctors refer their female patients for acupuncture with positive results, scientists have found that male patients can also benefit from acupuncture. Research studies have found that after acupuncture treatments significant improvements in the structural quality of sperm, improved sperm motility, higher sperm counts and an increased fertilization rate have occurred.
If you are struggling to have a baby, any information about options that may increase your rate of success is helpful news. Both sperm washing, as an assisted reproductive technique, and acupuncture to enhance both male and female fertility (and health!) can add to the choices and options that you may make on your fertility journey. If you have any questions about acupuncture and fertility, please give us a call.
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Dr. Jeda Boughton is a Doctor of Traditional Chinese Medicine and Registered Acupuncturist in Vancouver. She is also a Registered Herbologist and the founder of BodaHealth.
