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Dr. Smith,
Regarding IUI sperm preparation, I have read there can be a considerable difference in the post-wash recovery numbers depending on the andrologist's skill and wash technique used. What would you consider a decent % recovery from the total pre-wash motile count?
For our last IUI, my total pre-wash count was 162 million with 43% motility. I was surprised the post-wash recovery was so low: 21 million total with 85% motility. The report says the method was "isolate wash." Any thoughts? Thanks in advance.
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Using the density gradient centrifugation technique (i.e. the commercial product "Isolate"), a recovery of 20-40% of the motile sperm is considered normal (calculated as: [i]total[/i] number of motile sperm recovered / [i]total[/i] number of motile sperm in ejaculate). Note, these are totals, not sperm concentrations. Several factors can act to reduce the overall recovery of motile sperm from the ejaculate. These include: increased viscosity of the semen, abnormally high concentration of sperm in the semen, increased percentage of dead/immotile sperm, increased percentage of abnormally shaped sperm. In your case, the recovery was probably reduced by the higher than normal percentage of immotile sperm in the ejaculate (the maximum should be 50% and you had 57%).
IUI pregnancy rates increase as more motile sperm are used for insemination, up to 10 million motile sperm. Above 10 million motile sperm the pregnancy rate plateaus. Again, this is the [i]number[/i] of motile sperm used for insemination, not the [i]concentration[/i] of motile sperm in the washed preparation.
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