Andrology Laboratory

Male factor infertility is a contributing factor in approximately 45% of infertility cases. Therefore, the male partner should receive a thorough evaluation by a laboratory experienced in diagnosing male factor infertility.

The Jones Institute Andrology Laboratory, established in 1980, is one of the premier laboratories in the United States designed exclusively for clinical laboratory evaluations of male infertility. It was one of the first reproductive laboratories in the nation to achieve certification by the Health Care Financing Administration mandated by the Clinical Laboratory Improvement Amendments of 1988 ( CLIA - 88 ).

We continuously research new methods of evaluating male infertility, are familiar with the most recent discoveries in the specialty, and use the most updated methods / techniques of evaluation and performing laboratory tests. Many methods currently utilized in other laboratories were discovered in our Jones Institute laboratories.

Our program is one of the few in the country employing a full - time PhD andrologist devoted solely to semen analysis, sperm cryopreservation, and male factor infertility research. Since 1980, we have performed thousands of semen evaluations for Jones Institute patients and others throughout the world.

We consider every evaluation as unique as the patient being evaluated. We use our experience and expertise to insure that our methods and results are as updated, accurate, comprehensive, and informative as possible. Our reports are accompanied by an interpretation useful for clinicians and patients, as well.

Our laboratory director, Mahmood Morshedi, PhD, HCLD, CTBS, has been with the Institute since 1989. He has published numerous studies in scientific journals and is an authority on male infertility and laboratory evaluations for male infertility.

Additional services provided by the cryopreservation laboratory include sperm cryopreservation, providing donor sperm, cryopreservation of various other tissues, and long term storage of tissues ( including sperm ) cryopreserved elsewhere.

Cryopreservation

The Andrology Laboratory operates a separate comprehensive sperm / tissue cryopreservation laboratory as well as a donor sperm program to assist couples who desire to have children through artificial insemination using a male donor ( AID ).

Our donor program began in 1985 as one of the first cryopreservation laboratories in the United States to achieve CLIA certification. We offer sperm cryopreservation services:

• for patients with cancer
• for men before vasectomy
• for men who have undergone vasectomy reversal and are under evaluation for scar formation and blockage
• for men receiving treatments such as chemotherapy or radiation therapy, which may affect their reproductive systems
• for absent husbands of spouses undergoing infertility treatment
• for men who simply want to preserve their sperm for future use

These services offer couples the hope of having children in the future even if the male partner's ability to produce viable sperm is impaired. We also provide services for the long term storage of various samples cryopreserved elsewhere. Our special vapor phase storage facility is the best system available for preventing cross contamination of various samples that may be positive for infectious diseases.

Donor Sperm Bank

For the past eight years, we have worked closely with couples considering artificial insemination utilizing a donor. We are one of the few programs that assist patients / couples directly with the donor selection process rather than providing a "donor catalog."

In addition, we have implemented a series of strict guidelines for the selection and screening of our donors. Accordingly, each donor applicant's medical and genetic history is evaluated and a complete physical examination is performed. Laboratory screening is provided through 18 major blood tests, which include screening for sexually transmitted diseases and recreational drug use.

We also test for genetic diseases such as Tay - Sachs, alpha and beta thalassemia, and sickle cell. We currently have a bank of more than 75 donors available for selection. Our patients are required to furnish us with a written description of their physical characteristics and medical and genetic history. Based upon this information, several matching donors are identified. All pertinent information is provided to the couple for consideration and final approval.

For additional information, please contact us using the patient contact form or telephone 757 - 446-5029.

Reproductive Options for HIV-Serodiscordant Couples

Advances in the management of HIV infections have provided many affected patients a chance to feel healthier, live longer and increasingly plan for the future. For some of these patients now, the hope is that their future will hold the promise of parenthood. The epidemiology, treatment and prognosis of HIV infection have changed so markedly that none of the arguments once used to justify avoiding pregnancy or infertility treatment are as compelling as they were. It has been reported that between 70-80% of HIV+ individuals are of reproductive age. Many of these individuals are men who have become partners of uninfected women or are women cohabiting with uninfected men. In such circumstances, attempts to have children without preventive interventions pose the risk to the spouse and to the child to be born. Risk taking is one of the hallmarks of human nature. From the public health point of view, it has become a matter of concern that once the anxiety for the life (or living) among HIV-infected individuals is diminished, natural conception without regard to its associated risks may be attempted.

Added to the concern is the fact that the efficiency of HIV transmission from an HIV+ man to a seronegative woman in developed regions of the world (i.e., North America) has been reported to be eight times higher than the transmission rate from an infected woman to a seronegative man. Even with greatly improved methods of prevention, the danger of contracting the infection from the partner and infecting the child exists.

In 1998, we initiated several research studies to assess the effectiveness of the methods to reduce the viral presence in the semen samples from HIV-positive men using vigorous sperm processing and washing methods. Additional validation studies were also carried out by adding very high copies of HIV RNA to negative semen samples followed by processing of these samples in order to evaluate the effectiveness of the HIV removal using our processing methods. Our results have indicated that these methods are efficient in reducing the viral load (HIV RNA) in semen of HIV+ men to below the detection levels. We are now offering these methods to HIV serodiscordant couples in an attempt to assist them to have children. For safety reasons, at this time we offer sperm processing in conjunction with in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).

Thus far, 12 couples have utilized our services. Of the 12 couples, 9 have been successful achieving pregnancies (75% of the couples) resulting in deliveries of 12 babies from these attempts. We have had a set of triplets, one set of twins and 7 singletons. The oldest children (twins) are now 8 years old. Mothers have been tested for the presence of HIV-1 infection at 1,3,6,9 and 12 months after the initiation of pregnancies. Similar testing has been performed for some infants at 3, 6 and 12 months of age. There has been no seroconversion in these women and the offspring tested. For more information, please contact Dr. Morshedi at 757-446-5029 or e-mail cryo@evms.edu.

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601 Colley Avenue, Norfolk, Virginia 23507 Phone 800-515-6637 or 757-446-7100

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