The benefits of sperm washing - How procedure treats infertility
Did you know that you could have your sperm washed?
While the concept may sound like something that could be done in Frankenstein's lab, the truth is that the sperm-washing procedure has long helped couples who had difficulty conceiving because of having certain diseases as a barrier.
Couples who have one partner infected by HIV, for example, can use the sperm-washing process to "wash" the one partner's sperm to conceive a healthy, HIV-negative newborn.
But how does the whole process work? Is it safe? Most importantly, what other diseases can sperm washing ward off?
We spoke to Aziza Cassim, the manager at BioArt Fertility Centre in Johannesburg, and asked her the A-to-Z of sperm washing.
Cassim started by explaining exactly what sperm is, and what components it contains in order to understand exactly how it is washed.
"In a normal male's ejaculation, there are two components. There is the seminal plasma, which forms the bulk of the liquid portion, and the spermatozoa or sperm cells themselves, which is a small fraction of the total volume.
"The seminal plasma is important for the activation and performance of the sperm cells themselves. The spermatozoa or sperm cells are little tadpole-like structures which have the ability to swim through the female genital tract," Cassim said.
"In order for the sperm to become fertile they need to be activated and undergo certain important changes to the sperm head."
Cassim says that when doing a sperm wash the seminal plasma is cleansed and unwanted debris such as antibodies, bacteria and viruses are washed.
"In addition, the sperm are given a high degree of motility [faster movement].
"Special medium is used to perform the wash and if incorrect techniques are used or inappropriate solutions are used this could be detrimental," she says, adding that careful consideration must be given to temperature control as sperm movement is highly sensitive to temperature changes.
"Sperm washing is done as a routine when doing advanced routine-based fertilisation of eggs such as IVF and ICSI [injecting sperm into eggs]."
So how do you wash sperm? What exactly is involved in the procedure?
Cassim says sperm washing is performed in a laboratory after an ejaculate sample is collected. She says that there are three different methods of sperm washing available: the simple sperm wash, the density gradient method and the swim-up technique.
"The density gradient sperm wash is one of the most popular sperm-washing methods and one that we use most often. This is because it also works to separate dead sperm cells, white blood cells, and other waste products from the sperm.
"A test tube is filled with multiple layers of liquids of different densities. Semen is then placed on the top layer of liquid and the test tube is spun in a centrifuge. After it is spun, active, healthy sperm will make their way to the very bottom layer of liquid in the test tube, while debris and dead sperm will get caught in the top two layers. These layers can be siphoned off in order to remove the active sperm from the test tube. This sperm is then used in the insemination procedures," she says.
Cassim says that different types of men can benefit from sperm washing. These include males with poor sperm motility, those who have antibodies, those who have infections including HIV, or have ejaculatory problems (premature ejaculation and retrograde ejaculation) and patients in whom sperm count is subnormal.
Cassim adds that the procedure can also benefit females who have anti-sperm antibodies in the cervix or cervical canal abnormalities.
Many people have often wondered if sperm washing can also help with preventing the passing on of certain genetic disorders, and Cassim is quick to point out that this is unfortunately not the case.
"Sperm are only washed from external aspects and not internal - so the genetic content of the sperm is not altered," she says.
Just like with any procedure, Cassim warns that sperm washing does come with its own fair share of risks and that it is important to find a reputable clinic that knows what it is doing.
"If sperm washing is done incorrectly or by an inexperienced person, it may result in an allergic type of reaction due to high prostaglandins. In rare instances it may even cause a shock reaction and severe intrauterine spasm."
Cassim says that there is no age restriction to sperm washing and that an average routine insemination is between R2000 and R5000.