Office-based sperm concentration: A simplified method for intrauterine insemination therapy
Background: Intrauterine insemination (IUI) could become preferred to more invasive and expensive techniques of assisted reproduction therapy (ART) and should be offered as the first choice in cases with no female factors and mild male factor subfertility. However, developing countries and especially their rural areas often lack the necessary equipment and laboratory facilities.
Objective: To describe a simplified one-step method to determine the sperm concentration range for IUI therapy.
Methods: Semen samples from 51 sperm donors were used. Following swim-up separation, the sperm concentration of the retrieved motile fraction was counted, as well as progressive motile sperm using a standardised wet preparation. The number of sperm in a 10 μL droplet covered with a 22 × 22 mm coverslip was counted under 400 × total magnification. The observed numbers of retrieved motile sperm were divided into three groups: <40, 40 - 100 and >101 spermatozoa as recorded per intial estimation on the wet preparation.
Results: The mean (standard deviation) estimated sperm concentration for each group compared with actual counts per Neubauer counting chamber were: estimated <40 sperm (n=14), mean 20 (8), Neubauer count 2.5 × 106/mL; estimated 40 - 100 sperm (n=14), mean 71 (15), Neubauer count 16 × 106/mL; and estimated >100 sperm (n=23), Neubauer count 48.3 (21.7) × 106/mL.
Conclusion: The results with IUI in male subfertility cases reported by Ombelet et al. in 1995 support the concept of first-line treatment of infertility by three to four cycles of IUI therapy in selected cases.