WHAT WE DO AND WHY WE DO ITJUMANA ADHAM HUSSEINI

LAB DIRECTOR/SENIOR EMBRYOLOGIST

What We Do and Why We Do It

Our Bundles Of Joy

The Inside Story

Highest Pregnancy Rates In UAE

Semen Analysis

Liquefaction

Volume Count /ml /

(Total) Motility Progressio

n Morpholog

y Agglutinati

on

WHO (Criteria) 5th edition 2010-2013

Lower reference limit

Conc. 15m/ml (total 39m/ml)

Volume (1.5mls) Total motility 40% 32% progressive

motility Normal forms 4%,

(yet 15% normal forms defines teratozoospermia.)

Important Point to Remember

Severe reduction in fertilization might arise when < 4% strictly normal forms are present.

Abnormal spermatozoon under scanned microscope

http://www.reproduccioninfo.com/infertilidad/analisis-semen.html

Other Parameters Color Odor Opaque and grayish

white Changes to

yellowish white as days of abstinence ↑.

Blood gives it a reddish brownish color.

↓ conc. And WBCs ► transparent and watery consistency.

The odor of the flower of the chestnut plant.

Odor is caused by oxidation of the spermin secreted by the prostate.

Absence of odor ► Abnormal prostate function due to infection

The pH SHOULD BE WITHIN RANGE ( 7.2-8) Human semen should liquefy at pH

6.9-8.8 within 20- 30 minutes. > 8 → Acute prostatitis, vesiculitis or

bilateral epididymites. <7 → Obstruction of ejaculatory

ducts, only prostatic fluid secreted. <7.2-► <6 → chronic infection.

Liquefaction Vesiculase Seminine (Alpha) α-chymotrypsin Lysozyme Hyaluronidase α- Amylase Prostatic spec. antig. / prost. Acid

phos. None Liquefaction ≥ 1 hr. ► Prostatic

infection or other pathological state!?

1-FRUCTOSE

A sperm metabolite Done to check that ducts are normal.

Fructose levels are androgen dependant

↓Low levels →androgen deficiency

2- L-CARNITINE

Epididimal function is marked by L- carnitine. (↑ levels →none -Obstructive azoospermia. ↓ levels→ obstructive azoospermia. (post epididymal)

3- (PAP) Prostatic Acid Phosphatase

Prostatic Activity is Measured by seminal Acid Phosphatase (PAP)

↑ Acid phosphatase → obstructed ejaculatory ducts. (↓ semen volume, ↓ fructose.)

PAP test determines the health of the prostate.

Other tests4-Transferrin

5- Zinc and Selinuim

Sertoli cells are the source of 80%.

Very ↓ indicate Azoospermia.

↓ Low in oligospermia.

↑Highest in normal men.

Essential for germinal cell differ., and normal spermatogenesis, and sperm function.

Selenium deficiency leads to anomalies of neck and midpiece.

Zn ►chromatin decondensation.

Important Definitions Normozoospermia Oligoz0ospermia Asthenozoospermia Teratozoospermia Oligo-astheno-terato-

zoospermia Necrozoospermia Azoospermia Aspermia Cryptozoospermia

RECOMENDATIONS

Repeat /Semen AnalysisIUI/ IVF/ ICSISURVIVAL EVALUTIONVITALITY STAIN (EOSIN)SSU (♀♂) Selective swim upDNA FRAGMENTATION.SPERM ANEUPLOIDY

Vitality staining

The Sperm Marathon

http://axom3.com/blog/2012/11/%D7%AA%D7%95%D7%A1%D7%A3-dha-%D7%9E%D7%A9%D7%A4%D7%A8-%D7%90%D7%AA-%D7%90%D7%99%D7%9B%D7%95%D7%AA-%D7%94%D7%96%D7%A8%D7%A2-%D7%95%D7%9E%D7%92%D7%91%D7%99%D7%A8-%D7%90%D7%AA-%D7%A4%D7%95%D7%A8%D7%99/

http://skylineimaging.co.uk/still-images/

http://www.kadinlarkulubu.com/portal/saglik/azospermi-nedir-micro-tese-ameliyati-nedir-37668.html

FERTILIZATION

From Fertilization to Implantation

EGG COLLECTION

Cumulus Oocyte Oopherus

Abnormal oocytes

Mature & Immature eggs

Photo of a very immature eggCorona and cumulus cells are tightly packed around the egg

IVF image of a mature egg on the day of egg retrievalWe call this the metaphase II, or "M2" stage The presence of the polar body (red arrow) shows that the egg is mature

IMPORTANT DEFENITIONS

IVF ICSI COMBINED

IVF/ICSI (split) CRYOPRESERVATI

ON (VITRIFICATION)

PESA/TESA/TESE

PGS PGD

...

IVF

ICSI

2PN stage Embryo

Embryos

THE HATCHING BLASTOCYST

THE DIFFERENCE BETWEEN IVF AND ICSI

IN IVF NATURAL SELECTION THE ZONA PELLUCIDA IS ABLE TO IDENTIFY GENETICALLY ALTERED SPERMATOZOA

GENETICALLY ALTERED SPERMATOZOA WITH POOR MOTILITY AND DNA DAMAGE HAVE LOW FITNESS IN OOCYTE FERTILIZATION

IN ICSI THE NATURAL PROCESS OF SPERM /OOCYTE INTERACTION IS BYPASSED.

PESA/TESA

(FNA)Fine Needle Aspiration

TESA / TESE

Cryopreservation