In IVF/ICSI cycles, the fertilization occurs in the laboratory. The entity created after fertilization is known as embryo. Normally, the embryos are allowed to grow for 2-3 days before transferring into a woman’s uterus. However, depending on the number and quality of these embryos, it may be decided to let them develop further in the laboratory, for 5-6 days before implanting them in the uterus. During this time the more cells develop within the embryo and this stage is known as the ‘blastocyst’.

Advantages of blastocyst culture and transfer

• The embryo which survives for 5-6 days is considered strong and robust. It has better potential for successful implantation and pregnancy.
• This reduces the chances of having fraternal (dizygotic) twins, where two eggs are fertilized by two sperm and produce two genetically unique children. however, there is a chance of conceiving identical (monozygotic) twins (one fertilized egg splits and develops two babies with exactly the same genetic information)
• Reduced the chanses of multiple pregnancy.
• Higher success rate as compared day-3 embryos transferred.

Semen Analysis

Semen analysis is a series oftests performed to check the viability of a male sperm in case of male infertility.

Semen Analysis Test Results

Once a lab gets your semen sample, it will look at it under a microscope to check for the following:

Semen volume: Per WHO, normal volume of the ejaculate is between 1.5–5 ml. Low volumes could indicate a blockage or dysfunction in the seminal vesicles or prostate.

Sperm density: Sperm density or sperm concentration measures evaluates how many million sperms are present inonemilliliter of ejaculate. Per WHO, 15 million or more sperms in 1 ml of semen can be considered normal. Lower numbers may indicate oligozoospermia, a sign of male infertility.

Total sperm count: Total sperm countis the total number of spermatozoa in the entire ejaculate. By WHO, the lower reference limit (5thpercentile) is 39 million per ejaculate.

Motility: Sperm motility should be in the range of 40-50%. Low motility can indicate that there is toxin exposure such as smoking, alcohol, harmful chemicals, caffeine, hormonal problems or a varicocele (varicose veins in the scrotum).

Morphology: Morphology refers to the shape of the sperm. A low number of normally shaped sperm can decrease the chances of pregnancy.

pH: Per WHO, normal pH is 7.2-7.8.A low pH level means the semen is acidic, while a high pH level indicates it is alkaline. An abnormal pH can affect the health of the sperm and its motility.

Fructose Level: Fructose provides energy for the sperms. Absence of fructose may indicate a problem with the seminal vesicles.

Liquefaction: During ejaculation, semen is thick. It takes about 20-30 minutes before it becomes liquid. Liquefaction time measures how long it takes before it becomes liquid. If yours takes longer, or doesn’t become liquid at all, it could mean there’s a problem.

Preparing for the Semen Analysis

Here are a few things to keep in mind before giving the sample:

• Your doctor may ask you not to have sex or masturbate for 2 to 5 days before the test to make sure your sperm count will be as high as possible.
• Don’t avoid ejaculation for more than 2 weeks before your test. That can result in a sample with sperm that are less active.
• Avoid alcohol before your semen analysis.
• Certain medications or herbal supplements can affect the results. These include supplements that boost this testosterone or muscle-building steroids

For accurate results, another semen analysis may be performed within 2 to 3 weeks. This is because semen samples from the same man can vary.