Androlog Mail
In response to Dr. Muhterem Yalcin's query concerning IUI in the
presence of sperm antibodies:
let the patient ejaculate in a container containing 10-15 mL of the
media you routinely use to wash semen this will dilute the antibodies
and may decrease the exposure of spermatozoa to antibodies. Then
you centrifuge the semen as soon as possible and perform swim up. If you
face problems with increased viscosity you may aspirate the diluted
semen in large syringe and inject it back using small needle 25G. This
may be difficult due to frequent plugging of needle but it will reduce
viscosity.
Usually in such case centrifugation will increase the sperm auto
agglutination, but still free motile spermatozoa will swim up and can
be retrieved. However, antibodies may still be attached to free
spermatozoa as washing does not remove them. This may explain the poor
results of IUI in such cases.
Best of luck
Ibrahim Fahmy, MD
Andrology department, Cairo university.
Consultant Andrologist. Egyptian IVF-ET center
ifahmy@idsc.gov.eg
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