Sperm swim-up: a simple and effective technique of semen processing for intrauterine insemination.

OBJECTIVE To study the impact of sperm swim up technique of seminal processing for the purpose of intrauterine insemination (IUI) in couples presenting with subfertility. METHODS Hundred and twenty-one couples presenting with subfertility underwent 281 cycles of IUI in Combined Military Hospital Kharian, Lahore and PNS SHIFA Karachi from June 2002 to March 2005. Men had prior semen analysis to assess for parameters like those that total sperm count, morphology and progressive motility. Only those couples were enrolled in whom there was either no obvious cause or the male partner had some problem with the seminal counts/motility. In standard swim-up technique, after liquefaction, the semen sample was centrifuged and supernatant was discarded. Pellet was suspended in pre-warmed 2.5 ml of Ham's F-10 culture medium and thereafter centrifuged once more. The pellet was gently over-layered with medium in the tube which was sealed, inclined at 45 degrees and kept at 37 degrees C for 60-90 minutes in 5% CO2. A sterile Pasteur pipette was used to remove the supernatant containing actively motile sperms. The specimen was kept at 37 degrees C till dispatched to be inseminated. Data was analyzed by using SPSS version-10. Motility and morphology were used to present qualitative parameters and chi-square test was applied to assess the effectiveness of IUI in relation with these variables. RESULTS Post swim-up semen parameters including total motile sperm count and motility were observed. There was a trend towards an increased sperm count, motility and pregnancy rate after the swim up procedure. CONCLUSION Our findings suggest that sperm swim-up technique is an easy reliable and effective sperm processing method for insemination purposes.