Our laboratories have been fully inspected and accredited by the Reproductive Laboratory Program of the College of American Pathologists (CAP) and the Commission for Office Laboratory Accreditation (COLA). In addition, we are enrolled in proficiency testing programs with the American Association of Bioanalysts (AAB).

A two-cell embryo results after the first cleavage. This cell division occurs about 24 hours following fertilization.

Approximately, 36 hours after fertilization, the four cell stage appears.

Three days after fertilization, the embryos are at the 4 or 8 cell stages. Some embryos may be transferred to your uterus and the remaining are cultured for an additional two days. Embryos that continue their development are frozen two days later.

Five days after fertilization, the embryos reach the blastocyst stage. This stage represents the first cellular differentiation. Some cells will become the trophoblast (placenta) while others will give origin to the embryo proper. Embryos at this stage can be transferred fresh to the uterus or cyropreserved for future frozen transfers. After our initial studies with other mammalian embryos, we understand that embryos have different metabolic requirements during their development. Therefore, we have been using, successfully, a two-stage embryo culture system for human embryos. The results are impressive!

Andrology

Our laboratories have been fully inspected and accredited by the Reproductive Laboratory Program of the College of American Pathologists (CAP) and the Commission for Office Laboratory Accreditation (COLA). In addition, we are enrolled in proficiency testing programs with the American Association of Bioanalysts (AAB).

Male Factor Infertility plays a significant role in reproductive disorders. The infertility specialist must rely on adequately controlled sperm function tests to achieve an accurate diagnosis. The therapy alternatives involving sperm processing that the physician offers to their patients, such as IUI, should be carried out under environmentally controlled conditions utilizing the most rigorous methods. The Andrology Laboratory at the Infertility & IVF Center offers you and your physician a wide range of specialized sperm testing and sperm processing alternatives..

Basic Semen Analysis

Although the semen analysis is not a test of fertility, it is the most important single indicator of the functional status in the male reproductive tract. Clinical studies of infertile patients have established "limits of adequacy" below which the chance of initiating a pregnancy becomes more difficult. A minimum of two evaluations is recommended to establish a profile of the seminal parameters. In addition to sperm density, morphology, motility and live sperm, we record volume of the ejaculate, pH, viscosity, and presence of any other micro or macroscopic abnormal findings.

Sperm Function Tests

In addition, the Infertility & IVF Center offers a range of specialized sperm function testing for the evaluation of male fertility. These include:

1. Hemizona Assay, which evaluates the ability of sperm to bind to the zona pellucida
2. Sperm Antibodies in Male and Female, which determines the presence of antibodies bound to the sperm membrane (Direct) or the presence of circulating sperm antibodies in the female partner (Indirect)
3. In-Vitro Cervical Mucus Penetration Test, Which evaluates the ability of sperm to penetrate cervical mucus in-vitro. The patient’s sperm is compared against a control. In addition the assay can be used to determine if the partner’s cervical mucus is hostile to spermatozoa
4. Acrosome Reaction, which evaluates the proportion of sperm that undergoes an acrosome reaction
5. Hamster Sperm Penetration Test, which evaluates the ability of sperm to fuse, and penetrate enzymatically treated hamster eggs
6. Hypo-osmotic swelling, which determines the proportion of sperm that contain intact functional membranes.
7. Sperm Overnight Culture, From which a great deal of valuable information may be obtained ( i.e. we can learn if spermatozoa do not survive well in culture, or if they are contaminated with bacteria). If sperm motility after overnight culture is low we may customize the sperm processing methods to obtain the highest number of sperm with the longest survival time.

Sperm washing and concentration for IUI

We have the ability to make sperm preparations using conventional means. In addition, separation of highly motile spermatozoa can be done using gradient centrifugation, swim-up or a combination of these two. Conventional sperm washing requires about one hour, while gradient centrifugation and swim-up may need up to 3 hours to be conducted. Therefore, conventional washing can be conducted between 9-4 p.m. Mondays through Fridays and 9-11 on Saturdays. Gradient centrifugation and swim-up separation of sperm will only be conducted before 3 p.m. on week days. Please consult the office for other specific times if there is a conflict with the ones above.

Sperm Cryopreservation and Storage

This may be a necessary step for patients wishing to freeze their sperm before they are subjected to vasectomy or other treatments, such as chemotherapy or radiation, that may impair their ability to produce fertile spermatozoa. On the other hand, couples who have busy schedules which do not allow them to have intercourse around the ovulatory days, may opt to have frozen sperm available for IUI.

Cryopreservation

Cryopreservation of human sperm (Sperm Banking) was initially employed as an aid to circumvent certain forms of infertility. More recently banking of human sperm has been employed for a number of different reasons. Although this technique has been utilized in humans for more than two decades in the U.S, the potential expectations for the users are not clear. It is the purpose of this website to give you general information about it and help you make an informed decision if you elect to use sperm banking.

Bear in mind that the present information is only a guide based on estimations obtained from the American Society for Reproductive Medicine (ASRM). This does not constitute a guarantee that you are going to achieve a pregnancy with the cryopreserved semen specimens. Basically you are going to weigh your estimated potential to fertilize and produce a pregnancy against the estimated efficiency of the different existing alternatives to conceive and its costs.

Who needs sperm banking?

The most common use of human sperm cryopreservation is when anonymous healthy donors provide semen specimens to inseminate women whose partners cannot provide sperm with fertilizing ability. However, if you are in the group of fertile men who are contemplating a vasectomy, or face the necessity to be treated for cancer (chemotherapy and/or radiation) or any other procedure that might jeopardize testicular function and sperm production, then perhaps you may want to have some of your sperm frozen to be utilized later in case you cannot produce sperm in the future.

Can a single semen specimen be fractionated into several doses?

The standard procedure for freezing semen calls for specimens that have at least 20 million motile spermatozoa after thawing. Therefore, if you have an average or above sperm quality, then it may be possible to fractionate a semen specimen into several specimens. However, it may be questionable to do so if the sperm quality is below average.

How do I know the quality of my semen specimen?

The semen specimen is evaluated before freezing and after thawing . With the information gathered one can estimate the "Total Number of Normal Motile Spermatozoa" that survived freezing. This information, along with the number of specimens frozen and the kind of solution utilized to freeze the sperm, is given to you. We also keep a copy for our records.

How many semen specimens should be frozen?

The number of specimens to be cryostored may be different for each patient depending on social and biological factors. Your age, marital status, and number of children that you presently have are some of the social factors to consider. Semen quality, health, and your partner’s fertility status may be among some of the biological factors to keep in mind when deciding the number of semen specimens to have frozen. You should also consider the overall pregnancy rates and cost of the currently available reproductive technologies. Pregnancy rates for intrauterine insemination (IUI) or in-vitro fertilization (IVF) are about 20% and 40-70% respectively. For IUI you may need more than one ejaculate; for IVF a single one may only be necessary. For male factor infertility patients with very low sperm counts there is an additional technology available: Intra-Cytoplasmic Sperm Injection (ICSI). Once you weigh all the factors described above you may have an idea about the number of specimens you want to freeze. Lets suppose that in the best of scenarios you are a healthy male, contemplating a vasectomy, have an average or above sperm quality, have a stable family and children, and you want to have semen frozen just for "peace of mind", you may want to freeze a single ejaculate. In a different scenario if your sperm quality is below average, you have no children, and have health problems that may impair your ability to produce sperm, you may want to play safe and have more than one specimen frozen.

How is my semen specimen stored?

A semen specimen is stored in sterile plastic vials which are labeled with your name, ID #, and date of storage. The vials are attached to aluminum canes. Each cane can hold up to six vials. They are placed in special tanks that contain liquid nitrogen. The temperature of the liquid nitrogen is -196C.

In the event I move to a different city, can my specimens be transferred?

Yes, you can arrange to have your specimen sent to a facility in liquid nitrogen tanks for storage. Most cities with populations of 100, 000 or above should have one such facility. You will be, of course, responsible for any transportation fees.