RESUMO
OBJECTIVE: This study aimed to assess and compare sperm motility, concentration, and morphology recovery rates, before and after processing through sperm washing followed by swim-up or discontinuous density gradient centrifugation in normospermic individuals. METHODS: Fifty-eight semen samples were used in double intrauterine insemination procedures; 17 samples (group 1) were prepared with sperm washing followed by swim-up, and 41 (group 2) by discontinuous density gradient centrifugation. This prospective non-randomized study assessed seminal parameters before and after semen processing. A dependent t-test was used for the same technique to analyze seminal parameters before and after semen processing; an independent t-test was used to compare the results before and after processing for both techniques. RESULTS: The two techniques produced decreases in sample concentration (sperm washing followed by swim-up: P<0.000006; discontinuous density gradient centrifugation: P=0.008457) and increases in motility and normal morphology sperm rates after processing. The difference in sperm motility between the two techniques was not statistically significant. Sperm washing followed by swim-up had better morphology recovery rates than discontinuous density gradient centrifugation (P=0.0095); and the density gradient group had better concentration recovery rates than the swim-up group (P=0.0027). CONCLUSION: The two methods successfully recovered the minimum sperm values needed to perform intrauterine insemination. Sperm washing followed by swim-up is indicated for semen with high sperm concentration and better morphology recovery rates. Discontinuous density gradient centrifugation produced improved concentration recovery rates.
RESUMO
Postmortem sperm retrieval has been used worldwide in assisted reproduction technology. Nevertheless, the laws vary from country to country according to cultural, ethical and religious reasons. However, for postmortem sperm retrieval to be used, it is necessary that a preview informed consent be signed by the couple. In this study, we describe a case where the husband died during the in vitro fertilization (IVF) treatment prior to egg retrieval, but we had no informed consent with a paragraph concerning this issue. Thus, the wife had to request a judicial authorization, which was given in the case of an emergency by the judge, to retrieve genetic material from her husband after his sudden death. This case report demonstrates the importance of adding a specific paragraph in the informed consent to address this issue. Otherwise, this case may be a cause of a judicial battle to obtain consent for its use in in vitro fertilization.