The Impact of a Very Short Abstinence Period on Assisted Reproductive Technique Outcomes: A Systematic Review and Meta-Analysis

Barbagallo, Federica; Cannarella, Rossella; Crafa, Andrea; Vignera, Sandro La; Condorelli, Rosita A.; Manna, Claudio; Calogero, Aldo E.

doi:10.3390/antiox12030752

Cited by 7 publications

(3 citation statements)

References 46 publications

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“…Evidence from this study indicated that nancial constraints were a major barrier to accessing IVF treatment. Other studies have emphasized that the cost of IVF treatment can be prohibitively expensive for many individuals, potentially preventing them from pursuing such treatment [20,21]. The high cost of IVF treatment is a well-documented factor and seems to be particularly impactful in the context of Ghana.…”

Section: Discussionmentioning

confidence: 99%

Ethical concerns in the provision of in vitro fertilization treatment in Ghana: A qualitative study.

Appiah,

Ganle

2024

Preprint

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Background Infertility presents both medical and public health challenges, with in vitro fertilization (IVF) emerging as a prominent solution, particularly when other alternatives are exhausted. However, IVF treatment raises significant ethical questions that have been under explored in the Ghanaian context. This study aimed to explore ethical concerns regarding the provision of in vitro fertilization (IVF) treatment in Ghana. Methods A phenomenological descriptive qualitative design was employed. Purposive sampling techniques were used to recruit 12 participants from three in vitro fertilization (IVF) centres. In-depth face-to-face interviews guided by an open-ended interview guide were conducted. Thematic analysis of the interviews was performed to identify major themes. Results Providing IVF in Ghana raises several ethical issues, including inequitable access due to high costs and limited availability, which favour wealthier individuals and leave marginalized populations with fewer options. There are significant ethical considerations in balancing the potential benefits of successful IVF outcomes against the health risks and emotional tolls on patients. Decisions about the fate of surplus embryos present moral dilemmas, including whether to preserve, donate, or discard them. Differing personal beliefs about the moral status of the embryo further complicate the ethical landscape. Ensuring informed consent is challenging due to the complex medical, ethical, and emotional implications of IVF, potentially leading to compromised consent. Additionally, there are ongoing risks of breaches in confidentiality, given the sensitive nature of reproductive health data and the importance of protecting patient privacy. Conclusion This study revealed that several ethical dilemmas confront both healthcare providers and couples in the process of IVF. There is an urgent need for the development of clear and uniform regulations to govern the practice of IVF treatment in Ghana, with further attention given to mitigating financial barriers and enhancing support systems for couples considering IVF.

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Section: Discussionmentioning

confidence: 99%

Ethical concerns in the provision of in vitro fertilization treatment in Ghana: A qualitative study.

Appiah,

Ganle

2024

Preprint

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“…The association between very short abstinence and ART outcomes has been investigated recently in a systematic review and meta-analysis by Barbagallo et al ( 53 ). The authors demonstrated significantly improved ART outcomes—implantation, clinical pregnancy, and live birth rates—following very short abstinence, compared to standard, 2 days or more, abstinence period in men with altered sperm parameters.…”

Section: Discussionmentioning

confidence: 99%

Improved sperm DNA fragmentation levels in infertile men following very short abstinence of 3–4 hours

Karavani,

Juvet,

Lau

et al. 2023

Transl Androl Urol

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Background Limited data exists on possible approaches to improve sperm DNA fragmentation index (DFI) when no identifiable cause is found. The effect of short abstinence on sperm parameters has been extensively studied, but rarely reported on the effect on DFI in infertile men. In this study, we aimed to determine whether a second ejaculate provided after very short abstinence demonstrates lower DFI rates in infertile men. Methods This prospective cohort study was conducted at Mount Sinai Hospital, Toronto, Canada, a tertiary university affiliated hospital. All men having DFI testing in addition to the standard semen analysis were identified via a prospectively collected database. Infertile men were instructed to provide two semen samples 3–4 hours apart (the first sample was given after 2–5 days of abstinence) to test the effect on DFI levels. Data analysis was performed for the comparison of the change in sperm parameters and DFI between samples and between men with DFI above and under 30%. Results A total of 52 men provided double ejaculates 3–4 hours apart. In the entire group, DFI decreased from 38.9%±21.4% to 35.1%±21.6% in the second sample (P<0.001). Semen volume was lower on the second sample (2.3±1.4 vs . 1.5±0.9 mL, P<0.001), while the remaining parameters did not change. Forty out of 52 patients (76.9%) had improved DFI (average of 6.0±4.0 percentage points). Change in DFI varied with 22/52 (42.3%) and 7/52 (13.5%) of patients found to have decreases in DFI >5% and >10% in the second ejaculate, respectively. For men with DFI of 30–40%, 64% (7/11) of DFIs reduced to the under 30% range. First DFI value was the only parameter associated with DFI decrease to under 30% in multivariate models [odds ratio (OR), 0.62; 95% confidence interval (CI): 0.39–0.98; P=0.04]. Conclusions This study identified significant improvements in DFI in infertile men providing a second sample after 3–4 hours. Controlled trials are needed to determine if reproductive outcomes are improved using a second ejaculate for infertile men with high initial sperm DFI values.

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“…Notably, a compelling systematic review suggests that the current evidence indicates that shorter abstinence periods lead to better clinical pregnancy and live birth rates ( 37 ). Furthermore, a recent systematic review and meta-analysis performed to compare very short abstinence periods on ART outcomes found that the implantation rate, clinical pregnancy rate, and live birth rate among these treatment-seeking couples improved significantly ( 38 ). We found that a short-interval second ejaculation could lead to a higher clinical pregnancy rate, implantation rate and live birth rate, but there were no significant differences due to the limited sample size.…”

Section: Discussionmentioning

confidence: 99%

Short-interval second ejaculation improves sperm quality, blastocyst formation in oligoasthenozoospermic males in ICSI cycles: a time-lapse sibling oocytes study

Li,

Wang,

et al. 2023

Front. Endocrinol.

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BackgroundDoes short-interval second ejaculation improve sperm quality, embryo development and clinical outcomes for oligoasthenozoospermia males received intracytoplasmic sperm injection (ICSI) treatment?MethodsAll enrolled male patients underwent short-interval secondary ejaculation on the day of oocyte retrieval, and 786 sibling MII oocytes from 67 cycles were equally divided into two groups based on whether the injected spermatozoons originated from the first or second ejaculation. Semen parameters, embryo development efficiency, morphokinetic parameters and clinical outcomes were compared between the two groups to assess the efficiency and clinical value of short-interval second ejaculation in ICSI cycles.ResultsShort-interval second ejaculation significantly improved sperm motility, normal morphological rate, and sperm DNA integrity both before and after sperm swim-up. The high-quality blastocyst rate (24.79% versus 14.67%), available blastocyst rate (57.56% versus 48.44%), and oocyte utilization rate (52.93% versus 45.29%) were significantly higher in the second ejaculation group (P<0.05). The clinical pregnancy rate (59.09% versus 47.37%), implantation rate (42.11% versus 32.35%) and live birth rate (40.91% versus 31.58%) were higher in the second ejaculation group, but the differences were not significant (P>0.05). Time-lapse analysis showed that morphokinetic time points after the 7-cell stage were earlier in the second ejaculation group but without a significant difference (P>0.05), and abnormal embryo cleavage patterns between the two groups were not significantly different (P>0.05).ConclusionsShort-interval second ejaculation significantly improves sperm quality in oligoasthenozoospermic males, and is beneficial for blastocyst formation efficiency in ICSI cycles. This study suggested a non-invasive and simple but effective strategy for improving ICSI treatment outcomes.

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The Impact of a Very Short Abstinence Period on Assisted Reproductive Technique Outcomes: A Systematic Review and Meta-Analysis

Cited by 7 publications

References 46 publications

Ethical concerns in the provision of in vitro fertilization treatment in Ghana: A qualitative study.

Ethical concerns in the provision of in vitro fertilization treatment in Ghana: A qualitative study.

Improved sperm DNA fragmentation levels in infertile men following very short abstinence of 3–4 hours

Short-interval second ejaculation improves sperm quality, blastocyst formation in oligoasthenozoospermic males in ICSI cycles: a time-lapse sibling oocytes study

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