Ejaculatory abstinence in semen analysis: does it make any sense?

Abstract

Background: The precise effect of ejaculatory abstinence on semen parameters is highly debatable, especially among subfertile men. Previous studies on effect of abstinence time on different semen parameters have reported controversial results. The aim of this study was to retrospectively assess the variance of semen parameters with different periods of ejaculatory abstinence among both a population of normozoospermic ( n = 1621) and oligozoospermic ( n = 416) Tamil men, presenting to a fertility clinic for an infertility evaluation ( N = 2037). Materials and Methods: A retrospective analysis of 2037 semen analysis reports involved grouping patients based on their ejaculatory abstinence, that is, <24 h, 1 to 2 days, 3 to 7 days, 8 to 15 days, 16 to 30 days, and >30 days. All semen parameters were assessed as per the World Health Organization (WHO, 2010) recommended guidelines. The unpaired two-tailed t-test and Welch’s analysis of variance (ANOVA) combined with Games–Howell post hoc test were used for statistical analysis. A p value <0.05 was considered to be statistically significant. Result: A retrospective analysis of data ( N = 2037) identified no statistically significant differences in semen parameters of sperm concentration, percentage of progressively motile sperm, and normal sperm morphology in both normozoospermic and oligozoospermic individuals across different groups of abstinence. Semen volume was the only parameter that showed a statistically significant difference in both groups ( p < 0.0001). In both normozoospermic and oligozoospermic men, the group with <24 h abstinence had the highest mean percentage of progressively motile sperm and normal sperm morphology. Conclusion: The findings of this study suggest that ejaculatory abstinence may be highly arbitrary, and the recommendation of a strict 2- to 7-day abstinence per the WHO may be liberalized. In both normozoospermic and oligozoospermic men, semen parameters associated with an abstinence of <24 h were found to be noninferior as compared to longer ejaculatory abstinence intervals. These findings support in eliminating conservative recommendations as far as abstinence is concerned and suggest that patients may be asked to collect a semen sample on the day they present for an infertility evaluation, regardless of abstinence.

Current Insights and Latest Updates in Sperm Motility and Associated Applications in Assisted Reproduction

“…This was true for oligozoospermic men as well. Dupesh et al [47] reported that < 24 h abstinence in oligozoopermic men had highest percentage of progressively motile sperm and normal morphology. However, these studies reported lower sperm count and volume.…”

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

“…The abstinence time reported in the studies varied from less than a day (in 12 studies, with as short a time as 40 min [ 38 ]) to as long as 30 days or more [ 33 ]. The majority of studies (18 out of 24) compared the effect of short abstinence period (SAP; <2 days) with the WHO-recommended abstinence period (RAP; within 2 to 7 days) on sperm parameters or clinical outcome.…”

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“…4 It is now becoming clear that this concept cannot always be transposed to infertility clinical outcomes. [24][25][26] A large retrospective study that compared a long abstinence period (>7 days) with a standard abstinence period (2-7 days) reported significantly higher progressive motility and clinical outcomes in the second group. Within the latter, live birth rate was significantly higher in a subgroup of 2-4 days abstinence compared with the first group.…”

“…Indications regarding the length of the abstinence were mainly deduced from data reported from diagnostic semen analysis 4 . It is now becoming clear that this concept cannot always be transposed to infertility clinical outcomes 24–26 . A large retrospective study that compared a long abstinence period (>7 days) with a standard abstinence period (2–7 days) reported significantly higher progressive motility and clinical outcomes in the second group.…”

“…However, the results are controversial. For example, some researchers have reported that SARS-CoV-2 was not detected in the male reproductive tract, [25][26][27][28][29][30][31][32][33][34] while others reported that SARS-CoV-2 RNA was found in the semen or testes of COVID-19 patients. 35,36 There are also unknown factors regarding COVID-19 and male reproduction.…”