The Split Ejaculate

Abstract

Many couples are frustrated by infertility caused by deficiency in semen characteristics, e.g. oligozoospermia. This pathology has not been consistently corrected by medical therapy, but AIH using the split-ejaculate method has been offered as a reasonable alternative because of its simplicity and potential benefit. The distribution of spermatozoa in the semen of animals and man is not uniform throughout the entire ejaculatory process. A historical review of this phenomenon is shown in Table 1. By fractionating the seminal specimen during the ejaculatory process, one may use the more concentrated, better-quality portion in performing insemination in infertile patients. In man, the first part of the split ejaculate usually contains 76% of the total number of spermatozoa (MacLeod and Hotchkiss 1942). The ejaculatory process involves three events which occur in a characteristic sequence (Amelar and Hotchkiss 1965). A scant secretion from the Cowper’s glands initiates the ejaculation, is followed by the secretion from the prostate gland, the products from the testes, epididymes and the vasa deferentia. This is followed by secretion of the seminal vesicles. It is the first portion therefore of the ejaculate which normally contains the highest concentration of spermatozoa. This differential characteristic forms the basis for the use of the split ejaculate in AIH (Table 2). This phenomenon is true in about 80% of the cases. In 10%, the second portion contains the better quality and in the remaining 10% there is no difference.