The semen specimen should be collected by masturbation and the ejaculate produced into a sterile glass or disposable plastic jar that has been checked for sperm toxicity. As soon as the seminal plasma has liquefied, the specimen should be analyzed according to the WHO guidelines (6) and prepared for sperm isolation. A second semen specimen may be requested if the semen specimen on the day of IVF is of very poor quality (7). When liquefaction is delayed or the specimen is especially viscous, drawing the sample through a 21 gage needle into a syringe may help break up viscous globules. For men who are unable to collect semen by masturbation, nontoxic condoms are commercially available; guidelines for their proper use should be strictly abided by patient and laboratory personnel. Ordinary contraceptive condoms must not be used (even those without spermicide) because of their sperm toxicity. Coitus inter-ruptus is also not recommended because of the risk of incomplete recovery and potential iatrogenic contamination of the ejaculate.
Semen may be collected from men who are unable to achieve erection, emission, or ejaculation because of neurological or psychogenic problems by electroejaculation using direct vibratory stimulation of the penis or electrical stimulation of the prostate. Ejaculates from spinal cord injured patients will frequently have high sperm concentrations, decreased motility, and red blood cell contamination. Sperm may also be recovered from the urine of patients whose ejaculation is retrograde into the bladder. It is advisable that these patients be prescribed stomach-acid buffering medications to make the urine pH more hospitable for sperm.
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