A Comprehensive Guide to Sperm Optimization Prior to ART

This chapter summarizes the sperm preparation techniques for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), including the techniques in cases of epididymal or testicular retrieved spermatozoa, sperm selection for conventional IVF and/or ICSI including methods for the selection of immotile spermatozoa, and promising future sperm-handling methods. Sperm selection techniques may represent a breakthrough in assisted reproductive technique (ART), especially in cases of severe male factor. The ideal sperm selection method should meet the requirements of an ART clinic, where harmony must exist between reduced timing and labor quality; it should also be fast, inexpensive, easy to learn, repeatable, and efficient in improving pregnancy rates. However, sperm selection methods available to date have not shown to be beneficial for their routine use in the clinical practice and appear to be useful only in specific cases of male infertility. None of the countless number of methods have shown remarkable results in improving pregnancy rates. Advantages and disadvantages exist to all the sperm selection methods. Therefore, at this time, one cannot claim one method to be superior to other.