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Approximately 50 percent of the motile sperm retain motility when thawed. Sperm count, percent motility, and post-thaw viability will vary for each semen sample. Poor quality specimens do not freeze as well as normal semen samples. The number of motile sperm pre-cryopreservation required for medically assisted reproduction techniques ranges from less than 10,000 (in vitro fertilization with micromanipulation) to 20 million (artificial insemination). We will thaw a small portion of the specimen shortly after cryopreservation to determine the percentage of motile sperm that are expected to survive cryopreservation. This information will be valuable to physicians should you need a medically assisted reproduction procedure in the future.
Morphological Evaluation of Sperm
Evaluation of sperm morphology is a method to measure sperm quality. A small sample of the specimen to be frozen is fixed onto a microscope slide and two hundred sperm are observed and rated according to a standard set of values for head shape, length, width, and any other abnormalities that may be present. The ability of the sperm to fertilize an egg in vitro is correlated with the percentage of morphologically normal sperm in the ejaculate. This information will be important for selecting a medically assisted reproduction technique for future pregnancy attempts. A morphology slide will be retained by the Andrology Laboratory and will be evaluated upon physician request.
Couples with normal, pre-cryopreservation, sperm parameters (20 million motile sperm and >50 percent motility) may be able to conceive with intrauterine insemination. For intrauterine insemination the cryopreserved sperm are thawed, washed, concentrated in a small volume and inserted into the female's uterus on the day of expected ovulation. This procedure may be performed in a physician’s office and is the least expensive medically assisted reproduction technique and has a pregnancy rate of 15 percent per cycle. The optimal number of post-thaw motile sperm for achieving a pregnancy with intrauterine insemination is 10 million/insemination. Couples may wish to try this method first, while reserving enough frozen sperm for use in the in vitro fertilization program if a pregnancy is not achieved through intrauterine insemination. Health insurance plans may cover some or none of these charges.
Couples with less than 20 million motile sperm cryopreserved are likely to require IVF and embryo transfer. IVF facilitates the process of fertilization by inseminating eggs outside the body. Embryos resulting from this process are transferred to the uterus three to five days after the egg retrieval. Just over half of the women who undergo egg retrieval and IVF achieve an ongoing pregnancy at the University of Iowa. Pregnancy rates following IVF-ET decrease as the age of the female partner or the individual contributing the eggs increases. The cost for an IVF-ET procedure can range from $11,000 to $13,000. Health insurance plans may cover some or none of these charges.
Scheduling, Collection, Cryopreservation, and Storage Procedures
Scheduling
You may schedule an appointment at the University of Iowa Health Care Andrology Laboratory for sperm cryopreservation by calling 1-319-467-5299. Available appointment times are Monday through Friday, between 8 a.m. to 2 p.m. A physician requisition is required for all testing and must be received by the laboratory prior to scheduling an appointment.
Before you store a semen sample you need to be tested for the following infectious diseases:
HIV I/II Antibody
Hepatitis B Surface Antigen
Hepatitis C Antibody
If testing is done outside of UI Health Care, please have your referring physician’s office send us the test results.
Two to seven days of abstinence from ejaculation is recommended prior to the day of specimen collection to optimize the number of motile sperm in the ejaculate. You should schedule your appointments accordingly.
The Andrology Laboratory is located on the second floor of the University of Iowa Health Care North Dodge location. Patients should turn right after exiting the elevator and check in at the reception desk.
Specimen Collection
Rooms have been set aside for the purpose of semen collection in a private area. Your partner may accompany you to assist with specimen collection. In order to keep the specimen as sterile as possible, it must be collected into a sterile container by masturbation. The laboratory will provide a sterile, non-spermicidal lubricant if you require a lubricant.
Cryopreservation
The semen analysis will be completed approximately one hour after the specimen arrives at the laboratory. We evaluate the ejaculate volume, seminal fluid consistency, sperm count, and sperm motility. Following the analysis, the semen is diluted with a cryoprotectant to protect the sperm during cryopreservation and the specimen is transferred to cryovials. The average ejaculate will fill 1-3 vials. The sperm are then frozen in a controlled rate freezer and stored in a liquid nitrogen tank at -196o C. Sperm may be stored at this temperature indefinitely.
Storage
The UI Health Care Andrology Laboratory is a member of the Reprotech, Ltd. Fertility Preservation Network. The network is based on ReproTech's long history in sperm banking and their leadership and expertise in long term storage. The cryopreserved sperm will be sent to ReproTech for long-term sperm storage. For more information about ReproTech, please visit their website.
A Reprotech account must be created prior to the laboratory cryopreservation appointment. The Reprotech account can be set up online at www.reprotech.com/forms.
Results
Results may be viewed by patients via MyChart within 24 hours of testing. A final copy of the results will be mailed within seven business days to ordering physicians outside UI Health Care.
