Reproductive Testing and In Vitro Fertilization (RT-IVF) Laboratories

In Vitro Fertilization Program

University of Iowa Hospitals and Clinics Reproductive Testing and In Vitro Fertilization (RT-IVF) Laboratories’ services include:

• diagnostic andrology
• semen processing for intrauterine and in vitro insemination
• laboratory procedures associated with in vitro fertilization 

The laboratory has been accredited by the College of American Pathologists since 1995.

Evaluation of the Male Partner

To optimize your treatment outcome, it is important to identify and, when possible, treat seminal plasma and sperm factors that may diminish fertility potential.  The Reproductive Testing Laboratory and a male infertility specialist (andrologist) in the Department of Urology carry out investigation of male infertility.

1.   The following tests are required for the male partner:

a.   Two seminal fluid analyses
b.   Sperm morphology evaluation
c.   Sperm cryopreservation (freezing)

2.   These tests/procedures can be completed in two visits to the Reproductive Testing Laboratory.  Laboratory appointments for these tests should be scheduled with the laboratory secretary (office hours Monday through Friday 8 a.m. - 4:30 p.m., phone 319-384-8354).

3.   If any of the above tests are abnormal, a physician in the Department of Urology will evaluate the male partner.  Diagnosis and treatment of the factor(s) responsible for the reduced sperm quantity and quality may improve your chance of conception

The First Visit to the Reproductive Testing Laboratory

An appointment in the Reproductive Testing Laboratory will be scheduled during your preliminary appointment in the In Vitro Fertilization Clinic unless you instruct us otherwise.  You will be scheduled for a seminal fluid analysis, sperm morphology evaluation and semen cryopreservation (freeze).  The following four pre-requisites must be met prior to your appointment in the Reproductive Testing Laboratory:

1. Blood tests for HIV, Hepatitis (B surface antigen and C antibody) and RPR (Syphilis) must be completed and results available prior to your preliminary appointment.
2. In order to maximize the number and quality of sperm, PLEASE ABSTAIN FROM SEXUAL ACTIVITY FOR 2-7 DAYS PRIOR TO SEMEN COLLECTION FOR ALL TESTING AND IVF PROCEDURES.  Longer periods of abstinence (greater than 7 days) should be avoided, as this may increase the number of dead sperm in the semen and decrease the quality of the sample. 
3. You must have your green registration card before you proceed to the Reproductive Testing Laboratory.  This card is obtained at the registration desk on the first floor of the hospital.  Be sure to retain this card for all future appointments with the Reproductive Testing Laboratory.

Explanation of Tests

Seminal Fluid Analysis: The seminal fluid analysis (SFA) includes determination of ejaculate volume, sperm count, sperm motility, sperm speed, seminal fluid viscosity and other seminal plasma parameters.  Viscosity is a measure of how fluid the semen is 30 minutes following ejaculation.  Special laboratory procedures must be used when preparing sperm when semen has an abnormal viscosity.  Sperm speed is a measure of how quickly and vigorously the sperm are moving.  Slower moving sperm have a lesser ability to fertilize an egg than sperm that are moving at a rapid rate.

Morphology:  Sperm morphology evaluations are performed to assess sperm head shape, sperm tail defects, and to determine the percentage of sperm that appear to have normal morphology.

Post-ejaculate Urine Analysis: The post-ejaculate urine sample is evaluated for the presence of sperm.  Presence of a significant number of sperm in the urine is an indication of retrograde ejaculation (sperm released into the bladder).  Sperm can be recovered from the urine for assisted reproduction procedures.

Semen Cryopreservation: Semen is frozen before the treatment cycle to ensure that sperm will be available for oocyte insemination on the day of retrieval. The semen is frozen at a slow, controlled rate with a computerized system that ensures maximum sperm survival.

Semen Collection for Testing or Procedures

Days of abstinence (DC): In order to maximize the number and quality of sperm in the sample, please abstain from sexual activity for two to seven days prior to semen collection for all testing and treatment procedures.  Longer periods of abstinence (greater than 7 days) should be avoided, as this may increase the number of dead sperm in the semen. 

Specimen Containers: The semen sample must be collected into a special container provided by the Reproductive Testing Laboratory.  Please do not attempt to collect the semen into any other container, as this may result in decreased survival of the sperm.  Because the sperm will be used to fertilize the egg under sterile conditions, it is necessary to avoid bacterial contamination of the semen during collection.  This can best be accomplished by thorough washing of your hands and genital area prior to collection. 

Sample Collection Facilities: The semen must be delivered to the Reproductive Testing Laboratory within ten minutes after collection; thus the semen must be collected in the hospital.  A room has been set aside for the purpose of semen collection in a private area.  Your partner may accompany you to assist with specimen collection.  Specimens collected following coitus interruptus (i.e. withdrawal) are unacceptable. 

Sample Collection Method:

1. Masturbation with or without the use of lubricants is the best and preferred collection method.  All patients are strongly encouraged to use this method as it prevents specimen contamination and provides the most viable sperm population.   
   
   The laboratory provides a non-toxic lubricant in the collection room.  This is the only acceptable lubricant for semen collection.  Any other lubricants, such as Vaseline, K-Y Jelly, water or saliva, should not be used during sample collection because they will kill some or all of the sperm in the sample.
   1. For patients who, after repeated attempts, are unable to collect a sample by masturbation, nonspermicidal condoms are available from the laboratory for semen collection by intercourse.  This method is to be used only as a last resort as the risk of sample contamination and/or loss is greatly increased.

Explanation of test results

The normal ranges of parameters evaluated during seminal fluid analysis are presented below.

Seminal Fluid Analysis

* 1999 WHO Laboratory Manual for the Examination of Human Semen-Cervical Mucus Interaction (Fourth Edition).
** Days of Abstinence
***106 =1,000,000