Following a 2 – 7 day abstinence period, a semen sample is produced at the clinic through masturbation.

The sample is then evaluated using light microscopy to assess the exact amount of sperm present in the semen, how well the sperm swim, how many have a normal shape and any other additional testing as required per individual.

These values all provide insight into the fertility status of a male.

For this procedure the male produces a semen sample at the clinic following a 2-7 day abstinence period. This semen sample is then washed using density gradient centrifugation. The density gradient solutions used to wash the sample filter out any sperm that are unviable, debris and other cells that are detrimental in the sample.

This process increases the number of living, viable sperm and also activates the sperm making them swim more efficiently. The increase in these two semen parameters increases a couple’s chance of pregnancy.  The washed sample is then placed directly into the female’s uterus. Two weeks later the female partner will have a blood test done to determine if she is pregnant.

If a male partner is HIV positive, while his female partner is not, trying to conceive a child through natural conception will most likely result in the female partner contracting HIV.

To prevent this from occurring a semen decontamination procedure is available. Firstly, the patient must produce blood viral loads and CD4 counts that are satisfactory to the clinicians before producing a sample to be used for the wash procedure.

This sample will be washed using density gradient centrifugation and special apparatus to ensure that cross contamination does not occur during the washing procedure. A successfully washed sample can then be used for further assisted reproductive technology procedures.

It must be noted that this is a risk reduction method and that 100% chance of the sample not infecting the uninfected partner cannot be guaranteed, however, the chance of this happening is significantly reduced when compared to the couple trying to fall pregnant on their own.

IVF is an assisted reproductive technique involving the placement of mature eggs into a dish with washed sperm. This results in the egg being fertilised, still through natural selection, through increasing the chances of fertilisation dramatically by having the mature egg and normal sperm in close proximity to each other. The 6 main stages to an IVF cycle are:

  1. The administrations of medications to gain control of the woman’s cycle and ensure that multiple follicles are produced.
  2. The retrieval of eggs through a transvaginal aspiration.
  3. The insemination of the retrieved eggs through the above mentioned process.
  4. The culturing of any eggs that fertilise and grow into embryos for 3-5 days.
  5. The transfer of embryos/blastocysts into the female’s uterus for implantation to occur.
  6. The administration of medication to support the uterine lining to assist with implantation and maintaining pregnancy.

If there are any embryos remaining following the initial transfer these can be cryopreserved (frozen) to be transferred at a later stage if the first cycle fails or if more children are wanted by the couple at a later stage.

ICSI is a procedure mainly used to treat infertility stemming from severe male factor. In this procedure, a single sperm is injected directly into a mature egg that has been cleaned or stripped of its surrounding cumulus cells using a special enzyme. A special micromanipulation system with a micro-injector pipette and micro-holding pipette is used to catch a single sperm and hold an egg in place while the sperm is injected into it. The 6 main stages of an ICSI procedure are:

  1. The administrations of medications to gain control of the woman’s cycle and ensure that multiple follicles are produced.
  2. The retrieval of eggs through a transvaginal aspiration.
  3. The fertilisation of the retrieved eggs through the above mentioned process.
  4. The culturing of any eggs that fertilise and grow into embryos for 3-5 days.
  5. The transfer of embryos/blastocysts into the female’s uterus for implantation to occur.
  6. The administration of medication to support the uterine lining to assist with implantation and maintaining pregnancy.

Cryopreservation is maintained by storing samples in liquid nitrogen. This allows for samples to be safely stored in a usable state for many years if required. Semen cryopreservation is useful if the male partner for an IVF treatment works away from home often or in cases where cancer treatment such as chemotherapy is being started that will lower sperm count and semen quality.

For semen cryopreservation the male produces a semen sample via masturbation. They may be required to produce samples on multiple occasions to increase the volume of stored semen straws in cases such as cancer. Young females who are career driven may wish to cryopreserve their oocytes to be used at a later stage in life or also in the case of cancer treatment starting.

For oocyte cryopreservation the protocol for IVF will be followed up until the egg retrieval stage when they will then be cryopreserved instead of fertilised. Embryos are cryopreserved to prevent a couple having to restart the entire IVF procedure if pregnancy is unsuccessful on the first attempt. This helps prevent the female from having to take medication to increase follicle number again and having to redo the egg retrieval procedure.

Since not all viable embryos will be transferred on the first attempt the surplus embryos will be cryopreserved for future use.

Following a vasectomy a semen analysis can be performed to determine if any sperm are still present in the ejaculate. The semen sample is produced through masturbation around 4 months post surgery.

This sample is microscopically evaluated and if no sperm are seen the sample is then centrifuged and reassessed before being confirmed as azoospermic (no sperm present in the ejaculate).

Once the initial sample is confirmed as azoospermic a second sample must be produced, 2-4 weeks after this, and confirmed as azoospermic before the patient will be advised to stop using contraceptive methods.