In vitro fertilization or IVF is the most common type of fertility treatment that helps couples conceive and have a child through assisted reproductive technology. To form embryos, eggs and sperm of intended parents or donors are fertilized in a laboratory environment and are transferred to the woman’s uterus. For inseminating the gametes, eggs should be retrieved from the ovaries in an operation room. Sperm sampling for the IVF process should also be collected which is typically through masturbation.
In this article, we are going to take a look at all aspects of the sperm sampling for IVF. We will discuss subjects like “a good sample”, the number of sperm needed for IVF, the best way of sperm collection, improving sperm quality, attempts to do before sperm sampling, medications affecting sperm quality, and so on.
What is a good sperm sample for IVF?
A good sperm sampling for IVF should have a normal number, shape, and mobility. A sperm count is a very important factor that will help conceive a baby. If there is an abnormal sperm count, it can indicate an underlying health condition. Normal sperm counts range from 15 million to more than 200 million sperm per milliliter of semen. When there is a low sperm count, it is referred to as “oligospermia” and sperm count is above average when there are over 200 million sperm per milliliter. Sperm count will be determined through the “Sperm Analysis (SA)” test.
In male infertility, the number of sperm (volume), the shape of sperm, and sperm movement (motility) are all analyzed. For getting a more accurate semen analysis, your doctor may suggest testing three samples in different visits. The sperm sampling can be done at a fertility clinic, your doctor’s office, or at home.
What is the best way to get sperm for IVF?
The best and most common way to get sperm for IVF is masturbation, often on the day of oocyte retrieval. In some cases, intercourse using a special condom is needed for having a successful collection. Some men may be unable to ejaculate or when they do, there is no sperm in their semen sample. In this situation, a urologist collects sperm right from the testicle or the epididymis through a minor surgical procedure which is known as a Testicular sperm extraction (TESE).
If you want to do the sperm sampling at home, you must get the sample to the clinic’s laboratory within one hour. Sperm cannot live outside of the body or in an environment that has a fluctuating temperature for a long time. Sperm for IVF should be kept at a temperature similar to body temperature because if the sample gets too cold or hot, the sperm motility will decrease significantly.
Fresh sperm for IVF should be used immediately to fertilize the eggs. If fresh sperm is going to be used, sperm collection usually will be set on the day of egg retrieval and will be used to fertilize the egg through IVF. However, a frozen sperm sample can last for several years without losing its viability. In this way, the frozen sperm is thawed before the fertilization process and it will be saved for future use.
How many sperm samples are needed for IVF?
The amount of sperm for IVF in order to get pregnant depends on factors like the quality of sperm, the quality of the egg, and the choice of fertility treatment. Female fertility has a major role in fertility treatment and determines the number of sperm straws needed to fertilize the eggs. Another important factor in terms of fertility is age because once people, especially women, become older, their number of gametes and their quality decreases.
In general, the possibility of getting pregnant with IVF differs from one person to another. It is possible to use the first sample of sperm for IVF and form high-quality embryos and get pregnant or you may need to try for several cycles. Therefore, we often recommend our clients provide sperm samples 2 or 3 times to make sure when they come back to their own country and their IVF failed, they would have frozen sperm left here to start another IVF cycle.
How quickly can sperm quality improve?
Every day, men produce millions of new sperm which is good news for those who want to change their lifestyle and improve the quality of their semen. It takes about 74 days for sperm to mature. Therefore, if men want to change their lifestyle and have a healthier living by quitting smoking or having fresh food, they only need to wait for about 3 months to see improvements in sperm quality.
Improve sperm quality for IVF
There are simple steps that can help you produce healthier sperm for IVF with higher quality:
Maintain a healthy weight: researches show that increased body mass index (BMI) is linked with decreasing sperm count and lower sperm motility. So, it is optimal to have a normal BMI for having improved quality of sperm for IVF.
Have a healthy diet: eat fresh fruit and vegetables, especially those that are rich in antioxidants. Beef is loaded with all kinds of necessary nutrients for overall sperm health such as zinc, selenium, vitamin B12, carnitine, and more. Having liver, salmon, oysters, nuts, tomatoes, and garlic are among the recommended foods to improve the quality of sperm for IVF.
Prevent or treat sexual infections: sexual infections can cause infertility in men; therefore, taking precautions regarding the number of sexual partners and using condoms can help protect you against sexually transmitted infections.
Control stress: having stress will decrease sexual function and sperm production in men. If it is needed, you can ask for the help of your healthcare provider to talk with you about other patients’ experiences and help you manage your stress.
Exercise: having a routine exercise can increase the level of antioxidant enzymes, which can help protect sperm.
Quit smoking: smoking can lower sperm counts. To have high-quality sperm for IVF, you had better quit smoking some months before sperm sampling.
Limit alcohol: drinking too much alcohol can lead to reduced testosterone production, impotence, and decreased sperm production. If you are interested in drinking, you should have a moderate amount which is one drink a day for women and two drinks a day for men in case they are healthy adults.
Use supplements: taking supplements such as CoQ10, vitamin C, vitamin D, vitamin E, Folate/folic acid, Zinc, Selenium, and L-carnitine, under the supervision of your doctor seems to improve male fertility.
Avoid too much heat: high temperature can harm sperm production. Wearing loose-fitting underwear, avoiding saunas, steam rooms, and hot tubs, and limiting scrotum exposure to warm objects, such as a laptop may decrease sperm quality although it is not fully approved.
Does sperm have to be fresh for IVF?
Not necessarily. The researches show that frozen sperm performed as well as fresh sperm regarding the implantation rate and pregnancy success rate for both IVF and ICSI. Both fresh and frozen samples can lead to pregnancy and they have the advantage of giving more control over IVF cycles to couples. Thanks to the frozen sperm samples, couples can have IVF at the most convenient time without affecting their pregnancy rate.
What should you do before a sperm sample?
First of all, you have to make an appointment to collect your sample in the clinic or produce it at home and get it to the clinic quickly. Timing is very important regarding sperm sampling because sperm does not live long outside the body. You need to get the sample to the fertility clinic or lab in under one hour, meanwhile, you should Keep the semen sample close to the body or at a temperature of 350 C- 370 C.
You need to refrain from sexual activities that lead to ejaculation at least for two days and maximum 5 days. Each physician may have their own opinion for the duration of abstinence; thus, you need to check that with your doctor in advance.
Quit potentially unhealthy habits. It is recommended that at least for 10 days before the sperm sampling quit smoking, drinking too much, and taking medications that will decrease the sperm quality.
What precautions should be taken before a sperm test?
In order to have a proper sperm count, you should stop sexual activities for at least 2 to 3 days prior to the sperm test. However, this time cannot be longer than 7 days because it will decrease sperm quality.
Stop having too much alcohol or drugs for at least one week before the test.
Ensure that the laboratory has a standardized process and well-trained technicians.
Inform your doctor about medicines or supplements that you are using.
Wash your hands and your penis before starting to make sure they are clean.
Do not use a lubricant.
Try to ejaculate into the container. If a few drops spill out, do not pick up the semen.
If you want to collect the semen in a condom, you should not use a normal one. You can ask the fertility clinic for a special sterile condom. Try to be careful when removing it in order to prevent spillage.
What should I do before a sperm sample for IVF?
Before sperm sampling, you need to refrain from sexual activities for at least 2 days but not more than 5 days. Each physician may have their own opinion about the time of abstinence; therefore, you should check this with your doctor in advance. Longer or shorter periods of abstinence can result in a lower sperm count or decreased sperm motility. A semen sample after 2 days of abstinence will often have a higher number of alive and motile sperm compared to the semen that is collected in a shorter or longer period of time. It is good to know that refraining to ejaculate for a longer period of time is a mistake because older sperm starts to die over the time and the number of live sperm decreases.
What medications affect sperm?
There are some medications affecting male fertility. Nevertheless, you should not get terrified since most of the time their effect on fertility is reversible. You can talk with your doctor and ask for their guidance. In some cases, when you are taking a medicine that is interfering with your infertility, your doctor may replace it with a safer one.
Alpha-blockers such as “Rapaflo® and Flomax®” which are used to treat urinary symptoms can affect your fertility by stopping ejaculation or decreasing its volume. If you take these types of medications, visit a urologist to discuss the possible impacts and search for other treatment options.
Antidepressants are medications prescribed to treat depression and anxiety but they can cause sexual dysfunction. If you are taking Antidepressant medications, talk with your doctor about substituting other options that are less effective on fertility.
Chemotherapy medications are used to treat cancer. The bad news is all the chemotherapy medications used to treat cancer can affect fertility and decrease or stop sperm production. Your sperm production may return within two years based on the duration of your treatment and the type of chemotherapy you have received. However, sperm production may never return in many people. Therefore, if you are planning to start chemotherapy, you may need to consider freezing your semen prior to cancer treatment.
How sperm samples are collected?
A sperm sample is often collected through masturbation in the fertility clinic. For this purpose, you will be given a sterile sample cup to collect the semen sample in a room that has been set for this aim. Your doctor might ask you to refrain from ejaculation either through sex or masturbation for 2 to 5 days before providing the semen sample for IVF. They might also ask you to avoid smoking and having alcohol, drugs, and caffeine prior to the semen collection.
Since the quality of semen can vary day by day, your fertility clinic may want you to provide 2 or 3 semen samples for more accurate analysis. A private room is available for semen analysis in the fertility clinic. The semen sample is better to be provided by masturbation although other methods may also be discussed. You should not use any lubricant. Do not collect the specimen in a condom because they might affect the result of the analysis.
Try to take a shower and make sure that your hand and your body are clean. You need to ejaculate directly into the sterile container. If any sperm spills, do not transfer it into the container. Your fertility clinic will put a sticker on the container and write down your name, age, and the time of sampling on the container which you can double-check to make sure it is correct.
It should be noted that it is very common to feel a bit uncomfortable to providing a semen sample in a clinic. This is because you will be performing in an anonymous environment while the clinic staff knows that you are doing something that is usually private. You should keep in mind that sampling is a scientific process and the clinic staff are facing it every day. In addition, it is not uncommon to have difficulty ejaculating in the clinic due to stress and anxiety. If you have a high level of tension, you can do relaxation techniques or any activity that takes away your tension before doing the sampling. If you feel you will face trouble with ejaculation, talk to your doctor because they can help you find a solution.
Other sperm collection options
Sometimes there is no or very little sperm count in a semen sample which makes fertilization impossible. In addition, a blockage may prevent sperm to pass out of the penis during ejaculation. In such a case, a doctor may recommend a Testicular sperm extraction (TESE) in which the doctor makes a small incision in the testis and examines the tubules for the presence of sperm. In this procedure, the physician collects sperm for IVF directly from the testes.
For doing TESE, you should be fast and not eat anything after midnight before your surgery. You will get general anesthesia to be unconscious during the procedure. Your doctor will make a small incision in your scrotum and by using a tiny microscope, they remove small pieces of tissue from the testes. Once you wake up and be conscious, your will be discharged and it is safe to go home.
The Bottom Line
It can be strongly said that, considering the quality of the services, Iran is the cheapest country for IVF. TebMedTourism is a healthcare facilitator company, focusing on legal infertility treatment such as IVF, egg donation, surrogacy, gender selection, PGS, etc. with the most affordable costs. If you are interested to do IVF with the highest success rate in Iran, you can consult with our doctors free of charge and get your best medical plan. We can manage your trip by shortening the duration of your travel as much as possible, setting appointments with the top physicians of Iran, and getting the best IVF results for couples with any medical condition and various ages. To find the answer of your questions contact us now via WhatsApp!
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