Sperm capacitation refers to the process sperm go through after ejaculation, allowing the released sperm to gain the ability to fertilize the egg cell.
It involves a series of modifications in the structure and motility of the sperm. These allow the sperm to penetrate the thick membrane that surrounds the oocyte in order to be able to fuse together, resulting in an embryo.
This naturally occuring phenomenon occurs within the female reproductive system. It is simulated in vitro in order to reach success when using assisted reproductive technologies.
The different sections of this article have been assembled into the following table of contents.
When the sperm come into contact with the female reproductive system, they reach their final stage of development in which they acquire the ability to fertilize.
As they advance towards the Fallopian tubes, where they will find the egg cell, a series of transformations occur in a process that we call sperm capacitation.
Two major changes occur:
Once the spermatozoa are released in the ejaculate, the capacitation process does not happen at same time in all of them. As such, when they reach the egg cell, not all of them will have completed the process. Thus, those that are already capacitated at this point will have a higher chance of being the final winner of this race to fertilize the egg.
In a fertility treatment like Intrauterine Insemination (IUI), sperm do not go through the female reproductive system as they would in natural fertilization. Instead, they are directly placed inside the uterine fundus. For this reason, the molecular transformation that occur in vivo must be imitated to give the sperm the ability to fertilize the egg.
The same is true for in IVF cycles, whether they are done following the conventional process or using ICSI (Intracytoplasmic Sperm Injection). The sperm must go through the capacitation process outside the female body, as the egg-sperm fusion occurs in the laboratory.
Both procedures require pre-treatment of the ejaculated sperm in the laboratory that is known as in vitro sperm capacitation.
When done in vitro, the capacitation process can be performed using one of the following methods:
Thanks to these techniques, sperm are separated from the seminal fluid and are classified based on their motility and morphology. In this way, we can obtain a sperm sample with a higher concentration of sperm capable of fertilization.
Two or three culture media of different densities are used in an attempt to simulate each one of the phases the sperm go through naturally within the female reproductive system.
Media are placed in a test tube from higher to lower density, followed by the semen sample. After centrifuging the tube, sperm with the best qualities will have been able to overcome all the gradients and reach the bottom of the tube. This is the fraction that we separate and extract to perform the fertility treatment, as they are the sperm with progressive motility.
This is the traditional method we use for sperm capacitation in vitro. It consists of selecting the best spermatozoa based on their ability to move upwards in a particular culture media.
The sperm sample is centrifuged to gather all the cells at the bottom of the tube and remove the seminal plasma. Then, a specific culture media is added and the tube is left in an inclined position, so that the best quality sperm can swim upwards until they reach the edge.
After approximately 45 minutes, the upper part of the culture media is separated, which will contain sperm with progressive motility that will be later used for artificial insemination or IVF.
After capacitation, a drop is removed from the sample, to evaluate the quality of the sample before using it in a reproductive cycle.
The result of this analysis is given as the number of motile sperm with straight trajectories per milliliter of ejaculated sperm. It is known as Motile Sperm Count (MSC).
Indeed, sperm capacitation techniques are useful for two purposes: firstly, they allow us to find out the quality of the sperm sample before performing an IUI or IVF cycle. Secondly, because it also acts as a diagnostic test for male infertility.
In this sense, this process becomes what is known as MSC semen analysis or MSCN sperm capacitation test. It involves a basic semen analysis followed by capacitating the sample in order to determine, based on sperm quality, which reproductive technology to use.
Even though the following are orientative guidelines, sperm capacitation results are usually associated with assisted reproduction techniques in the following ways:
If you would like to read about this diagnostic study in more detail, please read our aticle: Advanced semen analysis: Evaluating the motile sperm count
A sperm wash or isolating procedure is used depending on semen factors at the time of the egg retrievall, in folliclar puncture.
Typically, if a semen sample is within the normal range, a gradient density isolation procedure is used. Alternatively, if a semen sample shows values out of the range of normal parameters, a washing procedure is used. If, in the initial infertlity evaulation a problem is dected in the male, our practice is to use the wash method, while the gradient density isolate procedure is used on men with normal sperm. Both procedures are result in sperm capacitation.
Sperm capacitation is the process by which the sperm acquires the ability to fertilize the egg. In the natural process, it occurs after ejaculation, when sperm enter the female reproductive system. In the laboratory we force this capacitation by means of of sperm washing in which, in addition, we select the best ones, eliminating the immotile ones and any substances that could be toxic for the spermatozoid.
In the laboratory, the duration of this process is between 30-60 minutes, depending on the type of capacitation we select. We can choose between:
To conduct a sperm capacitation procedure, you need a laboratory device called a centrifuge, along with the special media. Moreover, you need to know the steps involved in the process. In other words, it is not a process that one can carry out at home.
No one technique is better than the other. However, the density gradient centrifugation process allows us to obtain cleaner samples, that is, with a reduced percent of sperm with poor motility and other cells.
Choosing the most accurate method depends on the preferences of each fertility clinic, sperm quality, the fertility technique used etc.
Another option is to do a "mix" between the techniques described above. It would consist in using density gradient centrifugation and, with the resulting sample, perform a "swim-up" process. By doing this, we can obtain the best of the best.
Sperm capacitation is one more step in assisted reproduction techniques and, therefore, it is included in the price of these, whether it is artificial insemination or IVF.
If sperm capacitation is performed as a diagnostic test, that is, if we are going to perform a REM semen analysis, we can calculate the price of this process.
The sperm capacitation test is a test carried out on semen to evaluate the fertilisation capacity of the spermatozoa in the semen sample.
In order to carry out this analysis it is important that the patient maintains a period of abstinence of 3-5 days and collects a semen sample by masturbation.
Depending on the results obtained from the sperm capacitation test, the most recommended assisted reproduction technique will be chosen in each case.
As mentioned above, in vivo sperm capacitation occurs as the sperm moves through the female reproductive tract. If you want to know the path it follows, we recommend you visit the following article: How sperm meets egg: a journey from production to fertilization.
If you would like to read more information about the different assisted reproduction techniques depending on the result obtained in the REM semen analysis, we invite you to access this link: Assisted reproduction techniques: differences and complexities.
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