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108 lines
2.1 KiB
Markdown
108 lines
2.1 KiB
Markdown
---
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type: lab-results
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category: medical
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person: Yanxin Lu
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date: 2026-01-17
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provider: Advanced Reproductive Technologies, LLC / ART LLC
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source: lu_scrc_iui_sample.jpg
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---
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# Intrauterine Insemination Report — Fresh Sample
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**Medical Director:** Hal C. Danzer, M.D.
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450 North Roxbury Drive
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Beverly Hills, Suite 500
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CA 90210
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310.277.2393
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CLIA ID#: 05D0546234
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---
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## Patient & Partner Information
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| Field | Value |
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|---|---|
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| Patient Name | XUEWEI (ERICA) JIANG |
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| Patient ID | 105151 |
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| Patient Birth Date | 03/13/1993 |
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| Partner Name | YANXIN LU |
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| Partner ID | 105150 |
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| Partner Birth Date | 10/17/1989 |
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| Accession # | 480706 |
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| Ordering Physician | ART LLC |
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| ID Checked By | ART LLC |
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| Count Tech | DOG |
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---
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## Procedure Details
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| Field | Value |
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|---|---|
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| Date of Procedure | 01/17/2026 |
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| Abstinence Period | Day(s) |
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| Collection Date/Time | 01/17/2026 07:40 AM |
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| Collection Container | Sterile Cup |
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| Collection Method | Ejaculate |
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| Date/Time Recd in Lab | 01/17/2026 08:30 AM |
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| Reported By | |
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| Directed Donor Name | Desta Gebagay |
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---
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## Sample Analysis
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### Pre-Wash Values
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| Parameter | Value | Reference Values |
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|---|---|---|
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| Concentration | 3.0 ml | >= 1.5 mL |
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| Motility | 48 Million/mL | >= 15 million/mL |
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| Agglutination | 50% Progressive | >= 40% |
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| Round Cells | None | None-Minimal |
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| Progression | 0 Million/mL | < 1.0 Million/mL |
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| Total Motile Count | 72 M | 2+ to 3+ |
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| Media | 2+/3 | |
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| ALL (Grad Gradient) | | |
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### Post Wash Values
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| Parameter | Value |
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|---|---|
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| Volume | 0.5 mL |
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| Concentration | 40 Million/mL |
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| Motility | 83% Progressive |
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| Total Motile Count | 16.6 M |
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---
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**Comments:** Concentration and Motility values confirmed in duplicate
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---
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## Signatures
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**Physician Signature:** Dr. Candice Tilles
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**FDA Status:**
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**Reviewed and Electronically Signed By:**
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Lab Director: Desta Gebagay, C.L.S, ASCP
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**Sample Verification:**
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**Patient Signature:** *(signed)*
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**Witness Signature:**
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**Inseminated By:** *(signature present)*
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---
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**Test Performed At:** BH - ANDROLOGY
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Intrauterine Insemination Report — Fresh Sample - 1
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Powered by eIVF, a PracticeHwy.com product
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Printed: 1/17/2026
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