In association with International Society of Andrology
The 7th International Congress on Assisted Reproductive Technology and Advances in Infertility Management was organised by the Institute of Human Reproduction (IHR) at Guwahati, Assam, India from February 16 – 18, 2001, under the auspices of the Indian Society for Assisted Reproduction (ISAR). M. L. Goenka, Director, IHR and. Mehroo Hansotia, President, ISAR were the organising Secretary and President of the Congress respectively. Over 300 participants from all over India and neighboring countries including Bangladesh, Sri-Lanka, Bhutan attended the Congress.
A precongress workshop on Andrology on 15th February, 2001 was organised in association with the International Society of Andrology. All aspects of Semen Analysis as per the WHO manual, Sperm Banking and Sperm preparation for IUI were demonstrated. Sixty participants attended the workshop.
HWG Baker, Australia, representing ISA started the workshop with an excellent lecture on “Need for Standardisation of Semen Analysis”. Dr. Baker pointed out the large variations in semen reporting between laboratories and insufficient training of personnel doing semen analysis. He discussed the new edition (1999) of the WHO semen manual and stressed the need to follow universally accepted methods and reference values for better standardisation of semen analysis. Each laboratory must adhere to internal and external quality control schemes. He also talked about the rapidly advancing field of andrology and ART, thus the need for frequent Workshops and Conferences.
In his next lecture Dr. Baker talked about sperm motility assessment. He recommended simple grading of motility like Grade a, b, c, or d pointing out there is no need of complex equipments like CASA for routine semen analysis. Dr. Baker, with the help of video clippings, showed how to grade the motility of sperm.
James Catt, Australia, dealt with sperm counting and morphology. He demonstrated sperm counting using the improved Neubauer Haemocytometer and its accuracy, and stressed its use for sperm counting. He also demonstrated the quick counting method of live sperm using Makler’s Counting Chamber.
Dr. Catt stated that while assessing morphological normality of spermatozoa, we should adhere to Kruger’s Strict Criteria. All borderline sperms should be considered abnormal. Kruger’s Strict Criteria is helpful in predicting fertilisation in-vitro. In a semen sample if normal morphology sperm are less than 14%, it is recommended to advise IVF/ET, and if less than 4%, ICSI is suitable.
Dr. Goenka, described different techniques of semen preparation for intra-uterine-insemination (IUI). He demonstrated swim-up technique with EBSS media and discontinuous density gradient technique with PureSperm. Dr. Deepak stated that in cases of severe oligozoospermia and/or asthenozoospermia, density gradients are preferable to ‘swim-up’ method because of improved recoveries of sperm. One million sperm in 0.1 to 0.3 ml media must be inseminated for each IUI. If the yield is less than this the patient should be advised to undergo IVF/ET or ICSI. Instead of a single IUI, two IUI following HCG injection give better results.
Rupin Shah, India, talked about Non-surgical Semen Retrieval Techniques for IUI. He explained that many men fail to give a semen sample because of anxiety leading to anorgasmic anejaculation. Many of these men can achieve ejaculation by stimulation with a vibrator. Those who fail the vibrator will achieve ejaculation by electro-ejaculation. Since the later involves general anaesthesia, vibrator-stimulation is preferred as the first line of therapy. Sometimes, several attempts and prolonged stimulation of up to 2 hours may be needed before ejaculation occurs.
Deepak Goenka, India