In Vitro Fertilization IVF

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     The classic motility analysis is made by placing a small amount of semen (10-12μl), with a micropipette on a microscope lamella, covering it with another lamella (20×20 mm or 24×24 mm). It is very important that the semen volume and the lamella dimensions be standardized, thus the analysis is made on a solution of 25-30 μm thickness, which allows sperm’s complete rotational movement. The lamella helps spreading the sample in order to obtain an optimums effect automatically obtained by using a special extremely sensitive counting camera. The fresh solution is left for approximately one minute to stabilize. Conventionally, motility is measured in a laboratory with 18-24 C, although there are laboratories which perform the basic semen analysis at a 37 C temperature. Once the semen solution becomes stable, every sperm is counted starting left-up in a fork movement, while the solution is magnified at x400-600. In the microscopic field must be analyzed:
          a. rapid progressive motility,
          b. slow progressive motility,
          c. unprogressive motility,
          d. amotility.
     Sperm number in each category can be easier counted if there is a special counter. Usually sperms are counted approximately 100 in 4 up to 6 microscopic fields and are percentage assigned in each category.
     Therefore, immotile sperm number is measured, (A), then the entire sample is immobilized and then the total number of sperms is measured (B).
     Motility percentage (M) will be calculated according to the following formula:
M= (B-A/B)x100.
      A low motility percentage, below average is called asthenozoospermia, or asthenospermia, and it can be caused by varicocele, prolonged ejaculatory abstinence, ultra-structural or biochemical abnormalities of the spermatic differential flagella apparatus, the epididymal transport, or the existence of the antispermatic antibodies, usually associated with an infection or an inflammation.
     A motility percentage below 30% or the complete lack of sperm motility may indicate a serious problem like sperm amotility or sperm death (necrospermia). The percentage of dead spermatozoa cannot overcome the percentage of motile sperm. Immotile, though viable spermatozoa are fixed and then carefully analyzed with an electronic microscope with the scope of determining the flagella ultra-structural flaws.
     In modern infertility clinics, semen motility can be determined with automatic computer assisted systems, computer-assisted sperm analysis system, CASA.
     Another aspect which must be taken into consideration during a classical spermatogram, and, one which involves a complex series of tests, is the spermatozoa’s morphology. Furthermore we shall analyze the characteristics of normal spermatozoa, and the most common abnormalities which can occur in its morphology and thus stop the phenomenon of fecundation, therefore leading to infertility.

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