By Eulalee Thompson, Staff Reporter 
Denise Everett, embryologist at the University Hospital of the West Indies' (UHWI's) in vitro fertility laboratory, using the ICSI to inject a single sperm into a mature egg.
THE MACHISMO of Jamaican men notwithstanding, in far too many cases their sperm are either too weak to make the journey up the fallopian tube to meet the woman's egg, for fertilisation and pregnancy to take place or in some cases, they have no sperm to make the
journey.
Sometimes, creation actually needs a little assistance and this is where British-born embryologist, Denise Everett, enters the picture. A large chunk of her week is spent behind her microscope in the in vitro fertility (IVF) laboratory at the University Hospital of the West Indies' (UHWI's) Fertility Management Unit, analysing the quality of men's semen.
"In the future, myself along with the doctors, will do a research project on the quality of sperm in Jamaican men generally... but I think that it is comparable to the rest of the world, a lot of men have low sperm count or no sperm at all. Men with low sperm count are more devastated than women with fertility problems because the issue is tied (up) with their egos," said Miss Everett, who has gained varied experience working in countries such as Brussels, Italy, Turkey, Egypt and the United States.
She performs about 20 cases of semen analysis each month. She checks a variety of parameters including sperm count, motility and survival record all of which could affect male fertility.
"The results can range from normal to no sperm at all, in which case, we may have to do further investigation, perhaps a biopsy. Zero sperm count means that the man is not producing sperm or perhaps it is the case of a blocked tube, hormone imbalance, diabetes or perhaps the man is producing sperms but they are not coming out," Miss Everett said.
But all is not lost, for these men, assisted-reproductive technology is here to the rescue. Using the ICSI (intracytoplasmic sperm injection), the embryologist is able to retrieve a single sperm, then inject it into a mature egg from the female partner, wait for fertilisation to take place, then transfer the resulting embryo to the woman's uterus.
"Lots of the patients I see are interested in ICSI. Jamaican men are becoming more open-minded and they want to know about their sperm count and the quality of their sperm before they get married," said Miss Everett.
Some of them do become squeamish, however, when it comes to collecting the semen sample as they claim that they are reluctant to masturbate.
About one-third of the couples, wanting to be treated through IVF, have an issue with the sperm factor but on the woman's side there are also many issues to consider when infertility arises. There are possibilities of blocked tubes, sterilisation, fibroids, just not ovulating and even a category labelled as unexplained.
For IVF (or ICSI) procedures, the women are placed on a series of drugs in preparation for the egg retrieval process.
"The doctor punctures the follicle on ultrasound and fluid from the follicle is given to me
to retrieve the eggs...then we attempt to
fertilise...The following day, we check for
fertilisation then we inform the couple.
One or two days later (after fertilisation) the embryo is transferred to the mother's womb," said Miss Everett.
Since the IVF laboratory opened in 1999, the staff has treated about 150 patients for ICSI or IVF and with a success rate (pregnancy outcome) running about 33 per cent, the embryologist says that this compares well with the average rate of 25 per cent in similar facilities in countries such as the United Kingdom. In fact, Miss Everett said that with the last batch of 30 patients seen in September, the IVF laboratory is seeing a higher success rate, possibly reaching 40 per cent.
The pregnancy rate may be impacted because we have modified the drug protocol, the injection we are using is different and we are using a different culture media," she explained.
