Page 114 - PRECONGRESS COURSE 01

An Alternative View of Semen Assessment
Principles:
1. We cannot expect to be able to predict pregnancy.
2. We are not interested in trying to predict the likelihood of treatment “success” (e.g. fertilization at IVF).
3. Our real interest is in identifying the risk of specific failure using a particular therapeutic modality.
So the real question is:
Is gamete approximation and interaction going to work?
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A Functional Approach to Semen Assessment
 Why not just measure the biologically important aspects of human semen:
 The concentration of sperm that can get into cervical mucus: this is actually a sub‐set of WHO’99 grade “a“ progressive sperm
 The proportion of washed sperm that exhibit hyperactivated motility
 Sperm (functional) morphology
 Other pertinent aspects as required: e.g. DNA fragmentation, vitality, antisperm antibodies
 ...then use the results in deriving personalized treatment plans
 The sperm motility assessments rely on kinematic measures – which
require CASA
 Morphology, vitality, acrosome reaction testing, DNA fragmentation (Halo test) are current and emerging CASA tests
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