CPT® Code 58323

1. Indications

The procedure of sperm washing is indicated for the following conditions:

• Infertility Treatment Sperm washing is performed as part of the preparation for artificial insemination in couples experiencing infertility issues.
• Low Sperm Motility It is indicated when there is a need to enhance the quality of sperm, particularly in cases where sperm motility is low.
• Presence of Seminal Fluid Inhibitors The procedure is necessary when there are chemicals in the seminal fluid that may impair fertilization.

2. Procedure

The sperm washing procedure involves several key steps to ensure the effective separation of viable sperm from the seminal fluid.

• Semen Collection The first step involves the collection of semen, which is typically obtained through masturbation. In cases of retrograde ejaculation, a separately reportable collection procedure may be necessary to obtain the semen sample.
• Simple Sperm Wash In this technique, the collected semen is diluted in a test tube containing a solution that includes antibiotics and protein supplements. The mixture is then subjected to centrifugation, which causes the sperm cells to settle at the bottom of the test tube, concentrating the highly active sperm into a dense mass.
• Density Gradient Wash This method involves filling a test tube with multiple layers of liquids of varying densities. The diluted semen is placed on the top layer, and the test tube is centrifuged. During this process, debris, dead sperm cells, and white blood cells are trapped in the upper layers, while the active, healthy sperm are concentrated at the bottom of the test tube.
• Swim-Up Technique In this approach, the semen is placed in a culture dish that contains a layer of media culture designed to attract sperm. The viable sperm swim up into the media culture, and once a sufficient number of motile sperm have been collected, they are prepared for use in the artificial insemination procedure.

3. Post-Procedure

After the sperm washing procedure, the concentrated mass of viable sperm is carefully removed from the test tube and is ready for use in a separately reportable artificial insemination procedure. It is essential to handle the sperm with care to maintain its viability. The healthcare provider may provide specific instructions regarding the timing and method of artificial insemination following the sperm washing process. Additionally, monitoring may be recommended to assess the success of the insemination and any subsequent steps that may be necessary in the fertility treatment process.