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CRMRS laboratories have received Certification from CLIA and Accreditation by the Reproductive Laboratory Program of the College of American Pathologists (CAP). Our laboratories are also certified for human tissue handling by the Federal Drug Administration (FDA). In addition, we are enrolled in proficiency testing programs with the College of American Pathologists.
Male Factor Infertility plays a significant role in reproductive disorders. Up to 40% of couples may be facing male factor infertility. Additionally, there may be 20% of infertile couples that have a combination of male and female infertility. The infertility specialist must rely on adequately controlled sperm function tests to achieve an accurate diagnosis. The Andrology Laboratory at the Center for Reproductive Medicine & Robotic Surgery offers you and your physician a wide range of specialized sperm testing and sperm processing alternatives…
Although the semen analysis is not a test of fertility, it is the most important single indicator of the functional status in the male reproductive tract. Clinical studies of infertile patients have established “limits of adequacy” below which the chance of initiating a pregnancy becomes more difficult. A minimum of two evaluations is recommended to establish a profile of the seminal parameters. In addition to sperm density, morphology, motility and viability, we record volume of the ejaculate, pH, viscosity, and presence of any other micro or macroscopic abnormal findings (Strict Kruger criteria). Abstinence must be between 2 and 7 days. If the specimen is collected at home, it will need to be transported within 1 hour to the laboratory and kept warm in a sterile container. The patient’s name, date of birth, date and time of collection must be labeled on the container.
In addition, the Center offers a range of specialized sperm function testing for the evaluation of male fertility. These include:
We have the ability to make sperm preparations using conventional means. In addition, separation of highly motile spermatozoa can be done using gradient centrifugation, swim-up or a combination of these two. Conventional sperm washing requires about one hour, while gradient centrifugation and swim-up may need up to 3 hours to be conducted. Please consult the office for appointments.
This may be a necessary step for patients wishing to freeze their sperm before they are subjected to vasectomy or other treatments, such as chemotherapy or radiation, that may impair their ability to produce fertile spermatozoa. On the other hand, couples who have busy schedules which do not allow them to have intercourse around the ovulatory days, may opt to have frozen sperm available for IUI.
Cryopreservation of human sperm (Sperm Banking) was initially employed as an aid to circumvent certain forms of infertility. More recently banking of human sperm has been employed for a number of different reasons. Although this technique has been utilized in humans for more than four decades in the U.S, the potential expectations for the users are not clear. It is the purpose of this website to give you general information about it and help you make an informed decision if you elect to use sperm banking.
Bear in mind that the present information is only a guide based on estimations obtained from the American Society for Reproductive Medicine (ASRM). This does not constitute a guarantee that you are going to achieve a pregnancy with the cryopreserved semen specimens. Basically you are going to weigh your estimated potential to fertilize and produce a pregnancy against the estimated efficiency of the different existing alternatives to conceive and its costs.
The most common use of human sperm cryopreservation is when anonymous healthy donors provide semen specimens to inseminate women whose partners cannot provide sperm with fertilizing ability. However, if you are in the group of fertile men who are contemplating a vasectomy, or face the necessity to be treated for cancer (chemotherapy and/or radiation) or any other procedure that might jeopardize testicular function and sperm production, then perhaps you may want to have some of your sperm frozen to be utilized later in case you cannot produce sperm in the future.
The standard procedure for freezing semen calls for specimens that have at least 20 million motile spermatozoa after thawing. Therefore, if you have an average or above average sperm quality, then it may be possible to fractionate a semen specimen into several specimens. However, it may be questionable to do so if the sperm quality is below average.
The semen specimen is evaluated before freezing and after thawing . With the information gathered one can estimate the “Total Number of Normal Motile Spermatozoa” that survived freezing. This information, along with the number of specimens frozen and the kind of solution utilized to freeze the sperm, is given to you or your referring doctor. We also keep a copy for our records.
The number of specimens to be cryostored may be different for each patient depending on social and biological factors. Your age, marital status, and number of children that you presently have are some of the social factors to consider. Semen quality, health, and your partner’s fertility status may be among some of the biological factors to keep in mind when deciding the number of semen specimens to have frozen. You should also consider the overall pregnancy rates and cost of the currently available reproductive technologies. Pregnancy rates for intrauterine insemination (IUI) or in-vitro fertilization (IVF) are about 20% and 40-70% respectively. For IUI you may need more than one ejaculate; for IVF a single one may only be necessary. For male factor infertility patients with very low sperm counts there is an additional technology available: Intra-Cytoplasmic Sperm Injection (ICSI). Once you weigh all the factors described above you may have an idea about the number of specimens you want to freeze. Let us suppose that in the best of scenarios you are a healthy male, contemplating a vasectomy, have an average or above sperm quality, have a stable family and children, and you want to have semen frozen just for “peace of mind”, you may want to freeze a single ejaculate. In a different scenario if your sperm quality is below average, you have no children, and have health problems that may impair your ability to produce sperm, you may want to play safe and have more than one specimen frozen.
A semen specimen is stored in sterile plastic vials which are labeled with your name, ID #, and date of storage. The vials are attached to aluminum canes. Each cane can hold up to six vials. They are placed in special tanks that contain liquid nitrogen. The temperature of the liquid nitrogen is -196C.
Yes, you can arrange to have your specimen sent to a facility in liquid nitrogen tanks for storage. Most cities with populations of 100, 000 or above should have one such facility. You will be, of course, responsible for any transportation fees.
Embryos that are not selected for transfer in afresh cycle can be frozen to allow a patient to return for a frozen embryo transfer at a later time, with minimal medication, less expense and less stress. This may be an option after a failed IVF cycle, for a sibling of the child from the fresh IVF cycle and for family balancing (gender selection) after PGT-A.
Embryos can be frozen at various periods of development depending on the decision of the patient in consultation with her physician:
Oocytes are frozen at the day 0 stage after the retrieval. Typically, eggs are frozen at this stage to preserve fertility, prior to chemotherapy or other treatment that may affect the quality of the oocyte and affect a woman’s fertility. A patient may also elect to freeze eggs prior to entering into a permanent relationship and wishing to preserve eggs at her current age. Another reason to freeze oocytes may be an early onset of diminished ovarian reserve. This condition is usually seen in some families where the women undergo premature menopause (less than 40 years of age). In all of these instances, the oocyte is vitrified and will remain at that chronological age until it is thawed, fertilized with sperm, and cultured to embryo and then transfer back into the uterus.
Another common use for egg cryopreservation is to delay family for women who is currently in advanced stage of their education or early stage in their career. These women may freeze their eggs when they are young and years later when they are ready to start a family, they could use their frozen eggs to create an embryo and transfer them back into the uterus.
In addition, at our Center, we offer donor eggs to couple needing eggs. These recipient couple or women in same sex relationship can search donor egg database database and select eggs that are appropriate for them.