Why is sperm washed in infertility treatment and what are the downsides of that?
Sheldon Marks, MD:
Well when a couple is going in and it turns out that the numbers are pretty good, but she's still not getting pregnant but she's ovulating OK,one of the techniques is called intrauterine insemination. IUI.What we do is we take the sperm specimen from the man, we wash away all the accessory fluids and just maintain the sperm.And that's instilled up on the top of the woman's uterus on the day she's ovulating.That way the sperm are there much closer to the egg, and it improves the chances for conception. The problem with that is, the wash is very operator dependent.If you get a technician who doesn't know what he or she is doing, or doesn't care, or uses the wrong technique, then you could start off with a great numbers and great quality,highly motile happy sperm and end up with abysmal numbers, which means chances for success are low.So the problem is the art of the wash really has fallen by the wayside with advances in more complicated and modern techniques of in-vitro fertilization.
Why would a technician not care?
Sheldon Marks, MD:
The problem is a lot of technicians aren't trained. We had one lady once who brought us numbers before and after the wash, and the numbers afterwards were abysmal.So we called the doctor's office and asked, who did the wash, and what technique did they do?So a nurse came on the line, and she said, yeah, I rented a video from a medical source and I watched the video on how to do the wash.It was her first, and she did it on a Monday, and then they did the specimen.So it's really a very technically challenging procedure and if you don't know any better, if you've not been trained to realize that there are different washes you can do,and what an ideal number should be, then you're not going to know any better.