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HelpTest Code LAB1890 Sperm Prep Panel for IUI
Useful For
Analyzing and preparing a semen sample for an intrauterine insemination (IUI). For an IUI to be performed, the semen sample must be washed free of debris, white blood cells, and prostaglandins, which can cause the uterus to contract. The simple sperm wash should be performed on a sample that has a decreased concentration and/or motility.
Profile Information
| Test Component | Methodology | Always Performed | |
|---|---|---|---|
| Semen Analysis | Automated (SQA-Vision/WHO 5th Edition Criteria) | Yes | |
| Sperm Wash | Manual (Wash x2) | Yes | |
Performing Laboratory
Bozeman Health Outpatient Services at North 19th
Specimen Requirements
Specimen Type: Ejaculate
Container/Tube: Semen Analyisis Kit or clean, dry specimen container.
Specimen Volume: Entire specimen
Collection Instructions:
- Patient should have 2 to 7 days of sexual abstinence, unless otherwise specified by the provider.
- Collect entire specimen in the plastic specimen cup provided. Entire ejaculate is best collected by masturbation.
- Label container with patient’s name (first and last), date of birth, and date and actual time of collection.
- Maintain specimen at body temperature (37° C) by keeping the specimen close to the body during transport, or maintain at room temperature. Do not heat or cool the sample or container. Specimen must arrive within 30 minutes of collection.
- Complete the "Patient Collection" form and forward it with the specimen. Please read the special instructions below for more specific instructions.
Specimen Rejection:
1. Specimen collected in a condom.
2. Specimen not received within 30 minutes of collection.
3. Specimen received without completed patient collection form.
Special Instructions
Specimen Transport Temperature
Ambient/Body temperature (37° C)
Specimen Stability
| Specimen Type | Temperature | Time |
|---|---|---|
| Ejaculate | Ambient/Body Temperature (37° C) | 30 minutes |
Reference Values
Pre-wash Semen Analysis
Days of Abstinence: 2-7 days
Liquification: Complete
Appearance: Normal
Color: Gray-opalescent, Yellowish
Volume: ≥1.5 mL
Viscosity: Normal, Decreased
pH Semen: 7.2-8.0
Progression: Moderate, Rapid
Semen Count: ≥15.0 million/mL
Total Motility (PR+NP): ≥40%
Motile Sperm Conc: ≥6.0 millon/mL
Progessive Motile Sperm Conc: ≥5.0 million/mL
Functional Sperm Conc: millon/mL
Velocity: ≥5 microns/sec
WBC Conc: <1 million/mL
Additional Information
- During the semen washing, the sperm is separated from the other components of the semen and concentrated in a small volume. The sperm processing takes approximately 60 minutes.
Day(s) Test Set Up
Testing Hours:
Monday through Friday: 8:00 a.m. to 3:30 p.m
Saturday, Sunday: By appointment only. Weekend IUI's must be scheduled with N.19th Lab no later than 5pm the Friday prior.
Test Classification and CPT Coding
89260-Simple