TAILIEUCHUNG - Sperm Preparation for IVF and ICSI

Human spermatozoa at ejaculation are incapable of in vivo fertilization and must undergo maturational change during which they acquire the ability to fertilize oocytes. This process, known as capacitation, was described more than 50 year ago by both Austin (1) and Chang (2). Capacitation is prevented in ejaculated spermatozoa by at least one factor in seminal plasma (3). Additionally, prolonged exposure to seminal plasma can inhibit the ability of spermatozoa to undergo the acrosome reaction in vitro (4) and diminish their capacity to fertilize (5). In the female genital tract, motile spermatozoa separate themselves from seminal plasma, immotile spermatozoa,. | __9__ Sperm Preparation for IVF and ICSI Nancy L. Bossert and Christopher J. De Jonge Reproductive Medicine Center University of Minnesota Minneapolis Minnesota . INTRODUCTION Human spermatozoa at ejaculation are incapable of in vivo fertilization and must undergo maturational change during which they acquire the ability to fertilize oocytes. This process known as capacitation was described more than 50 year ago by both Austin 1 and Chang 2 . Capacitation is prevented in ejaculated spermatozoa by at least one factor in seminal plasma 3 . Additionally prolonged exposure to seminal plasma can inhibit the ability of spermatozoa to undergo the acrosome reaction in vitro 4 and diminish their capacity to fertilize 5 . In the female genital tract motile spermatozoa separate themselves from seminal plasma immotile spermatozoa and debris by actively migrating through the cervical mucus. This active migration selects progressively motile spermatozoa and allows them to undergo capacitation. Due to the inhibitory effects of seminal plasma on sperm function it is critical that spermatozoa used for clinical procedures such as in vitro fertilization IVF or intracytoplasmic sperm injection ICSI be separated from the seminal plasma as quickly as possible after ejaculation and liquefaction. Although IVF started as a treatment for tubal infertility the increasing number of men with poor semen quality led to the development of a variety of sperm preparation techniques. These techniques generally fall into four categories i simple dilution and washing ii sperm migration 147 148 Bossert and De Jonge iii density gradient centrifugation and iv filtration or adherence. Regardless of the technique the objective of sperm preparation is to recover an enriched population of motile and functionally competent spermatozoa while eliminating dead spermatozoa and other cells including bacteria and leukocytes. The technique should also minimize

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