Two subsequent seminal productions: A good strategy to treat very severe oligoasthenoteratozoospermic infertile couples

Abstract

Background: Sexual abstinence is considered one of the several factors that influence sperm quality. Recent studies show that a shortening of the abstinence period could be beneficial mostly in oligoasthenoteratozoospermic (OAT) patients.Objective: Retrospective study to verify the efficacy of a second semen sample after a short abstinence to treat severe OAT infertile patients.Materials and methods: 127 couples treated between May 2014 and May 2018 were divided into two groups. Study Group 1 (75 cycles): severe OAT characteristics: count <0.2 × 10 6 /mL no progressive motility; count ≥0.2 × 10 6 /mL and no total or progressive motility; 0% normal morphology; a second semen sample was requested after abstinence of 2 h. Control Group 0 (52 cycles): normozoospermic or mild OAT; only one sample was requested. Intracytoplasmic sperm injection was utilized in all cases.Results: All semen parameters were significantly different between Group 0 vs both samples of Group 1 (p < 0.001), excluding volume between Group 0 and 1st sample of Group 1 (p = 0.682). The comparison between 1st and 2nd samples from Group 1 showed significant differences in volume, total and progressive motility and morphology (p < 0.001, p < 0.001, p < 0.020) but not in total sperm count (p = 0.970).Fertilization, pregnancy rate/transfer, implantation and miscarriage rates were 85.9% and 61.1% (p < 0.001), 30.6% and 35.8% (p = 0.700), 17.5% and 24.0 (p = 0.292), 20.0% and 25.0% (p = 0.017) in Group 0 and Group 1 respectively. Discussion and conclusion:The results show that a short abstinence in severe OAT patients allows us to obtain spermatozoa with better motility. The request for a second semen sample in couples with extreme semen parameters is a valid and simple strategy that helps to achieve the same probability of pregnancy compared to a Control Group. Furthermore, it allows us to utilize fresh spermatozoa avoiding the need to resort to cryopreserved reserves or testicular surgery.

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

“…Twelve studies were excluded because they evaluated only the effect of a short period of abstinence on sperm parameters and not on ART outcomes. Finally, seven articles were included in the analysis [ 27 , 28 , 29 , 30 , 31 , 32 , 33 ] ( Figure 1 ). All studies were judged to be of moderate quality after assessment with the Cambridge Quality Checklists ( Table 2 ).…”

“…Seven studies evaluated the effects of a very short abstinence period on ART outcomes [ 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. Among these, three studies included IVF and embryo transfer (ET) cycles [ 27 , 28 , 29 ], whereas the remaining four studies evaluated ICSI cycles.…”

“…Ciotti et al performed a retrospective study on 127 couples treated with ICSI [ 31 ]. On the basis of the sperm parameters of the male partners, the couples were distinguished in two groups.…”

“…The data on the effects of a very short abstinence period on the FR could be extracted from five studies [ 28 , 30 , 31 , 32 , 33 ]. Barash et al also evaluated the FR.…”

Sperm DNA Damage and Its Relevance in Fertility Treatment: A Review of Recent Literature and Current Practice Guidelines

“…Similarly, Ciotti et al retrospectively compared 64 men with severe OAT (Group 1) to 52 men with normal semen parameters or mild OAT (Group 0) [ 88 ]. All men provided a fresh semen sample after 2–3 days of abstinence for use in an ICSI cycle.…”