The Development of a Simplified Swim-up Method for Sperm Processing

  • Moungala Lionel Wildy Androcryos Andrology Laboratory, Parktown, Johannesburg, South Africa
  • Laura Boyd Department of Obstetrics and Gynaecology, University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa
  • Jozef Fourie Panorama Fertility Laboratory, Mediclinic Panorama, Cape Town, South Africa
  • Opheelia Makoyo Department of Obstetrics and Gynaecology, Mere-Enfant Hospital, Libreville, Gabon
  • Carin Huyser Department of Obstetrics and Gynaecology, University of Pretoria, Steve Biko Academic Hospital, Pretoria, South Africa
Keywords: Developing countries, Infertility, Artificial insemination, Reproduction, Spermatozoa, Swim-up, Syringes

Abstract

Established sperm preparation techniques have been under the spotlight in support of the affordable assisted reproduction drive. Affordability and safety are particularly relevant in developing countries, with restricted access to basic infertility care due to limited resources. This study investigated a modified sperm swim-up method in comparison to a commercial sperm preparation kit. Spermatozoa were processed using three different volume disposable syringes: 5 ml (SW-5), 10 ml (SW-10), and 20 ml (SW-20), with respect to concentration and motility. Hereafter, the syringe method that resulted in the highest sperm yield was matched against a commercially available device (SEP-D kit) for the evaluation of sperm motility, concentration, vitality, morphology, and deoxyribonucleic acid (DNA) fragmentation. Semen processed using the SW-10 method resulted in a higher total motile sperm count (6.62 x106), in comparison to the SW-5 and SW-20 methods. When compared to the commercial device, spermatozoa harvested with the SW-10 method presented with significantly improved total motility (75.35% vs 87.05%) and concentration (14.35 x106/ml vs 17.10 x106/ml, p<0.0001). Furthermore, there was a significant increase in spermatozoa viability after processing using the SW-10 (79.47% vs 70.05 for the hypo-osmotic swelling test, 82.31% vs 72.00% for eosin and nigrosin test, p<0.001), and fewer spermatozoa with DNA damage (13.70% vs 23.20%, p<0.0001). This modified swim-up method can therefore be integrated into a cost-effective intrauterine insemination treatment for selected patients in a low-resource setting.

Downloads

Download data is not yet available.

References

Murage A, Muteshi MC, Githae F. Assisted reproduction services provision in a developing country: time to act. Fertility and Sterility. 2011;96(4):966-8.

Cooke ID. Public and Low-Cost IVF. In: Fleming S., Varghese A, (editors). Organization and Management of IVF Units. Springer, Cham. 2016; 301-314.

Chiware TM, Vermeulen N, Blondeel K, et al. IVF and other ART in low- and middle-income countries: a systematic landscape analysis. Human Reproduction Update. 2021;27(2):213–228

Huyser C. Affordable ART services in Africa: synthesis and adaptation of laboratory services. Human Reproduction. 2008;2008(1):77-84.

Ombelet W, Cooke I, Dyer S, et al. Infertility and the provision of infertility infertility medical services in developing countries. Human Reproduction. 2008;14(6):605-21.

Hammarberg K and Kirkman M. Infertility in resource-constrained settings: moving towards amelioration. Reproductive Biomedicine Online. 2013;26(2):189-95.

Van Blerkom J, Ombelet W, Klerkx E, et al. First births with a simplified culture system for clinical IVF and embryo transfer. Reproductive Biomedicine Online. 2014;28(3):310-20.

Siam EM. Pregnancy outcome after IUI for male and idiopathic infertility using a new simplified method for sperm preparation. Middle East Fertility Society Journal. 2012;17(1):30-36.

Franken D. Office-based sperm concentration: a simplified method for intrauterine insemination therapy. South African Medical Journal. 2015;105(4):295-7.

Ombelet W and Dhont N. Emerging cost-effective treatments including low-cost IVF. In: Stevenson JS and Hershberger PE, editors. Fertility and Assisted Reproductive Technology (ART): Theory, Research. 2016. 223- 231.

Ombelet W and Onofre J. IVF in Africa: what is it all about? Facts Views Vision in Obgyn. 2019;11(1):65-76.

American Society of Reproductive Medicine Committee. Patient's fact sheet: infertility. 2013; Available at: http://www.asrm.org. [Accessed 03/26, 2021].

Cohlen B. Should we continue performing intrauterine insemination in the year 2004. Gynecologic and Obstetric Investigation. 2005;59(1):3-13.

Nandi A, and Homburg R. Unexplained subfertility: diagnosis and management. International Journal of Clinical Obstetrics and Gynaecology. 2016;12(2):1-9.

Starosta A, Gordon CE, Hornstein MD. Predictive factors for intrauterine insemination outcomes: a review. Fertility Research and Practice. 2020;6(23):1-11

Boomsma C, Heineman M, Cohlen B, Farquhar C. Semen preparation techniques for intrauterine insemination (review). Cochrane Systematic Reviews. 2012;10(10):1-42.

Allamaneni SS, Agarwal A, Rama S, Ranganathan P, Sharma RK. Comparative study on density gradients and swim‐up preparation techniques utilizing neat and cryopreserved spermatozoa. Asian Journal of Andrology. 2005;7(1):86-92.

Gode F, Bodur T, Gunturkun F, et al. Comparison of microfluid sperm sorting chip and density gradient methods for use in intrauterine insemination cycles. Fertility and Sterility. 2019;112(5):842-848.

Zsot PAC and Ashok A. Practical Manual of in-vitro fertilization: Advanced methods and novel devices. New York: Springer-Verlag. 2012;185-99.

World Health Organization. Laboratory manual for the examination and processing of human semen. 5th edition. Geneva: WHO Press; 2010.

Rappa KL, Rodriguez HF, Hakkarainen GC, et al. Sperm processing for advanced reproductive reproductive technologies: Where are we today? Biotechnology Advances. 2016;34(5):578-587

Aitken RJ, Smith TB, Lord T, et al. On methods for the detection of reactive oxygen species generation by human spermatozoa: analysis of the cellular responses to catechol oestrogen, lipid aldehyde, menadione and arachidonic acid. Andrology. 2013;1(2):192-205.

Raad G, Bakos HW, Bazzi M, et al. Differential impact of four sperm preparation techniques on sperm motility, morphology, DNA fragmentation, acrosome status, oxidative stress, and mitochondrial activity: A prospective study. Andrology. 2021;9(2):1549-1559.

Zini A, Finelli A, Phang D, et al. Influence of semen processing technique on human sperm DNA integrity. Urology. 2000;56(4):1081-4.

Xue X, Wang WS, Shi JZ, et al. Efficacy of swim-up versus density gradient centrifugation in improving sperm deformity rate and DNA fragmentation index in semen samples from teratozoospermic patients. Journal of Assisted Reproduction and Genetics. 2014;31(9):1161-6.

Takeshima T, Yumura Y, Kuroda S, et al. Effect of density gradient centrifugation on reactive oxygen species in human semen. Systems Biology in Reproductive Medicine. 2017;63(3):192-198

Gentis R, Siebbert I, Kruger T, et al. Implementation of an office-based semen preparation method (SEP-D Kit) for intrauterine insemination (IUI): a controlled randomized study to compare the IUI pregnancy outcome between a routine (swim-up) and the SEP-D kit method: scientific letter. South African Journal of Obstetrics and Gynaecology. 2012;18(2):54-5.

Menkveld R. Sperm Morphology Assessment Using Strict (Tygerberg) Criteria. In: Carrell D., Aston K. (eds) Spermatogenesis. Methods in Molecular Biology. Methods and Protocols. 2013. Humana Press, Totowa, NJ.

Hamilton JAM, Cissen M, Brandes M, et al. Total motile sperm count: a better indicator for the severity of male factor infertility than the WHO sperm classification system. Human Reproduction. 2015;30(5):1110–1121.

Ok EK, Doğan OE, Okyay RE, et al. The effect of post-wash total progressive motile sperm count and semen volume on pregnancy outcomes in intrauterine insemination cycles: a retrospective study. Journal of the Turkish German Gynecological Association. 2013; 14(3):142–145.

van Weert J, Repping S, Van Voorhis B, et al. Performance of the postwash total motile sperm count as a predictor of pregnancy at the time of intrauterine insemination: a meta-analysis. Fertility and Sterility. 2004;82(3):612-20.

Ombelet W. Semen quality and intrauterine insemination. Reproductive Biomedicine Online. 2003;7(4):485-92.

Marzieh M, Nobakhti N, Atrkar R, Dashtdar H, Oudi M, Hosseini A. The correlation between semen parameters and pregnancy outcome after intrauterine insemination. Iran Journal of Reproductive Medicine. 2003;1(1):28-32.

Hauser R, Yogev L, Botchan A, et al. Intrauterine insemination in male factor subfertility: significance of sperm motility and morphology assessed by strict criteria. Andrologia. 2001;33(1):13-7.

Sun Y, Li B, Fan L, et al. Does sperm morphology affect the outcome of intrauterine insemination in patients with normal sperm concentration and motility. Andrologia. 2012;44(5):299-304.

Tandara M, Bajić A, Tandara L, Šunj M, Jurišić Z, Jukić M. Correlation between proportions of sperm with DNA fragmentation assessed by Halosperm test and values of standard quality parameters of semen and possible impact on embryo quality. Slovenian Medical Journal. 2013;82(5):1-4.

Published
2022-01-02
How to Cite
Lionel Wildy, M., Boyd, L., Fourie, J., Makoyo, O., & Huyser, C. (2022). The Development of a Simplified Swim-up Method for Sperm Processing. Journal of Infertility and Reproductive Biology, 9(4), 160-167. https://doi.org/10.47277/JIRB/9(4)/160
Section
Regular publication process (free of charge)