Effect of the sexual abstinence period recommended by the World Health Organization on clinical outcomes of fresh embryo transfer cycles with normal ovarian response after intracytoplasmic sperm injection

Abstract

This study was to investigate whether the sexual abstinence period (SAP) recommended by the World Health Organization (WHO) affects clinical outcomes. We compared the rate of clinical outcomes between 2-7 and ≥8 days of SAP in first fresh embryo transfer after intracytoplasmic sperm injection (ICSI) in groups of young maternal age (YMA: <38 years) and old maternal age (OMA: ≥38 years). We conducted a retrospective study of 449 first ICSI cycles with a normal ovarian response. SAP was identified before collecting the semen samples. Semen analysis was performed based on the guidelines recommended by WHO (2010). Sperm preparation was made using the swim-up method. Patients' baseline characteristics in the YMA and OMA groups did not differ. The rates of fertilisation, top-quality embryos on day 3, biochemical pregnancy, clinical pregnancy, ongoing pregnancy, abortion and implantation per cycle were not significantly different between 2-7 and ≥8 days of SAP in the YMA or OMA group. In conclusion, SAP beyond the recommended period by WHO was not associated with the rates of a lower fertilisation and pregnancy in human in vitro fertilisation (IVF). We think that a new criterion of SAP for clinical application in human IVF needs to be considered by WHO.

The impact of sociodemographic characteristics, lifestyle, work exposure and medical history on semen parameters in young Chinese men: A cross‐sectional study

“…We found that longer abstinence period resulted in increased semen volume ( β = 0.54, p = 0.004 and β = 1.07, p < 0.0001 for 3–5 days VS > 5 days), TSC ( β = 0.3, p = 0.025 and β = 0.62, p < 0.0001 for 3–5 days VS > 5 days) and sperm concentration ( β = 0.28, p < 0.033 for > 5 days) and was similar to an earlier research where the authors suggested that semen volume, sperm concentration and total sperm count increased significantly with abstinence length (Agarwal et al, ). Similarly, the fertilisation and pregnancy rate did not decrease with a longer abstinence period beyond WHO recommendation (Lee et al, ). The precise period of ejaculatory abstinence to provide maximum sperm quality remains controversial.…”

The Effect of Ejaculatory Abstinence Interval on Sperm Parameters and Clinical Outcome of ART. A Systematic Review of the Literature

“…Four studies did not restrict the abstinence time to WHO recommendations [ 17 , 33 , 35 , 40 ]. Two studies examined possible effects of long abstinence period (LAP) [ 41 , 42 ] on the clinical outcome.…”

“…Two retrospective studies compared the outcomes between the RAP (2–7 days) and the LAP group (>7 days). Lee et al (449 cycles) did not find any difference regarding implantation, clinical and ongoing pregnancy rates between the groups [ 41 ], while Periyasami et al (1030 cycles) found higher clinical pregnancy and live birth rates in the RAP group [ 42 ].…”

Impact of ejaculatory abstinence period and semen characteristic on the reproductive outcomes after intracytoplasmic sperm injection

“…They demonstrated that fertilization rate, top-quality embryos on day 3, and pregnancy rate were not significantly different between 2-7 and ≥8 days of abstinence. They have also suggested that the sexual abstinence beyond the recommended abstinence period by WHO (2-7 days) was not associated with lower fertilization and pregnancy rates in ICSI cycles ( Lee et al ., 2018 ).…”

“…Some studies have reported that a shorter abstinence period can improve pregnancy outcomes in intracytoplasmic sperm injection (ICSI) cycles (Colturato et al, 2007;Periyasamy et al, 2017;Borges Jr et al, 2019), but another group has reported no correlation between abstinence period and ICSI outcomes (Lee et al, 2015;. Lee et al (2018) have even indicated that the abstinence period beyond the recommended period of WHO did not decline pregnancy outcomes. Furthermore, semen samples collected after recurrent ejaculations and final abstinence of 12 hours could improve pregnancy outcomes in ICSI cycles (Sánchez-Martín et al, 2013).…”