Effect of ejaculatory abstinence period on sperm DNA fragmentation and pregnancy outcome of intrauterine insemination cycles:  A prospective randomized study

Kabukçu, Cihan; Çil, Nazlı; Çabuş, Ümit; Alataş, Erkan

doi:10.1007/s00404-020-05783-0

Cited by 14 publications

(17 citation statements)

References 39 publications

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“…In the literature, the influence of LEA on SDF is contradictory and debatable, 11,30,31 possibly because of technical differences in the assay used for estimating DNA fragmentation. A long LEA is believed to be detrimental to sperm DNA, possibly because of the presence of oxidative stress within the epididymal environment 32 .…”

Section: Discussionmentioning

confidence: 99%

Sperm characteristics in normal and abnormal ejaculates are differently influenced by the length of ejaculatory abstinence

et al. 2022

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Background:No association between the length of ejaculatory abstinence (LEA) and semen characteristics has been confirmed. A short LEA has been linked to improved sperm characteristics and a higher pregnancy rate, but its negative influence on sperm chromatin maturity and longevity may adversely affect reproductive outcomes. Objectives:We sought to determine the influence of LEA on (i) semen parameters in normozoospermic and abnormal ejaculates; and (ii) the outcomes of spermpreparation methods in a large number of subfertile men undergoing infertility workups. Materials and methods:This retrospective registry-based cohort study analyzed the data of 10,674 ejaculates from 7972 subfertile men, who were then segregated into normozoospermic, oligozoospermic, asthenozoospermic, and oligoasthenozoospermic cohorts. Variations in semen characteristics and post-wash outcomes were studied between four LEA intervals across 0-15 days.Results: An age-adjusted analysis of covariance (ANCOVA) model linked significant increases in ejaculate volume, sperm concentration (except in the oligozoospermic cohort), and total sperm count to an increased LEA (p < 0.05). LEA was negatively associated with motility (except in the asthenozoospermic cohort) and vitality (p < 0.05).Large-headed spermatozoa were less common with an increased LEA only in the oligoasthenozoospermic cohort (p < 0.05). In the normozoospermic cohort, a longer LEA led to fewer spermatozoa with amorphous heads but more spermatozoa with tapered heads and cytoplasmic droplets (p < 0.05). LEA extension resulted in greater sperm DNA fragmentation in the abnormal cohort (p < 0.01). The post-wash sperm concentration and total motile sperm count were significantly improved with a longer LEA in the normozoospermic cohort (p < 0.05). Discussion and conclusion:Considering the findings in this study and existing literature, a generalized recommendation for long LEA has no clinical value. The LEA should be individualized based on the ejaculate profile and the need for specific clinical intervention.

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Section: Discussionmentioning

confidence: 99%

Sperm characteristics in normal and abnormal ejaculates are differently influenced by the length of ejaculatory abstinence

et al. 2022

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“…One randomized controlled trial [ 30 ] compared IUI outcome between the SAP and RAP groups. In total, 120 patients were included in the study and the clinical pregnancy rate did not differ between the groups.…”

Section: Resultsmentioning

confidence: 99%

“…Unfortunately, we could only include one study evaluating ejaculatory abstinence time and the outcome of the IUI treatment [ 30 ] and this did not demonstrate any benefit for any particular abstinence time (one day vs. three days). The previously mentioned systematic reviews highlighted higher pregnancy rates after IUI when the semen sample was produced after less than two [ 19 ] or three days [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

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

Sokol

Drakopoulos

Polyzos

2021

JCM

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Since the publication of the first edition of the WHO (World Health Organization) Laboratory Manual for the examination of Human Semen in 1980, the reference values of sperm parameters have been updated on four occasions. Currently and globally, most of the laboratories analyzing semen samples use the latest, 5th edition of the manual that recommends ejaculatory abstinence from two to seven days before producing the sample for examination. While this standardized interval of time facilitates the interpretation of the results and research, no solid evidence exists to support the WHO-recommended abstinence time for a semen analysis in order to optimize clinical outcomes after assisted reproduction. Most of the studies refer to different clinical outcomes, different groups of patients and different editions of the WHO Laboratory Manual, including heterogeneous intervals of abstinence or sperm parameters. The aim of the current systematic review was to evaluate available evidence correlating ejaculatory abstinence time with clinical outcomes and sperm parameters analyzed according to the last edition of the World Health Organization Laboratory Manual reference values in different male populations. The results from the included studies indicate that WHO abstinence recommendations may need revision, given that a shorter ejaculatory abstinence interval appears to be associated with improved sperm parameters, such as sperm DNA fragmentation, progressive motility or morphology, while evidence suggests a potential increase in embryo euploidy rates and pregnancy outcomes.

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“…On the other hand, some studies documented that shorter ejaculatory abstinence, about 4–24 h, is associated with better sperm quality using conventional semen analysis than a longer abstinence period 14,17,18,20 . Interestingly, some recent studies revealed that abstinence length is only arbitrary and does not influence semen quality 13,19 . Hence, standardizing the recommended ejaculatory abstinence period remains pertinent for male infertility evaluation, and a successful spontaneous and assisted conception.…”

Section: Introductionmentioning

confidence: 99%

Influence of ejaculatory abstinence period on semen quality of 5165 normozoospermic and oligozoospermic Nigerian men: A retrospective study

Akhigbe

Hamed

Dutta

et al. 2022

Health Science Reports

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Background and Aims: Several studies have shown that the length of ejaculatory abstinence alters sperm quality. However, the available data are conflicting and none seems to exist in a Nigerian population. The present study aims to compare the semen quality in normozoospermic and oligozoospermic semen samples of a homogenous Nigerian population, following varying ejaculatory abstinence days (EAD); less than 2, 2-3, and 3-7 days.Methods: The present retrospective study included 5165 semen samples collected over 5 years, from April 2015 to April 2020.Results: In normozoospermic samples, sperm count and total sperm count were significantly higher in prolonged EAD. In oligozoospermic patients, semen volume significantly increased with prolonged EAD, while sperm count, total sperm count, and progressive motility were significantly reduced with prolonged EAD. In addition, EAD and sperm volume positively correlated in oligozoospermic patients. Conclusion:Our findings indicate that EAD affects sperm quality in both normozoospermic and oligozoospermic men with varying impacts. Prolonged EAD increased sperm count and total sperm count in normozoospermic patients, while EAD increased semen volume but reduced sperm count, total sperm count, and progressive motility in oligozoospermic patients.

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Effect of ejaculatory abstinence period on sperm DNA fragmentation and pregnancy outcome of intrauterine insemination cycles: A prospective randomized study

Cited by 14 publications

References 39 publications

Sperm characteristics in normal and abnormal ejaculates are differently influenced by the length of ejaculatory abstinence

Sperm characteristics in normal and abnormal ejaculates are differently influenced by the length of ejaculatory abstinence

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

Influence of ejaculatory abstinence period on semen quality of 5165 normozoospermic and oligozoospermic Nigerian men: A retrospective study

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