Increased count, motility, and total motile sperm cells collected across three consecutive ejaculations within 24 h of oocyte retrieval: implications for management of men presenting with low numbers of motile sperm for assisted reproduction

Abstract

Purpose The purpose of this study was to quantitate changes in seminal volume, sperm count, motility, qualitative forward progression, and total motile sperm cells per ejaculate, across three consecutive ejaculates collected from individuals within 24 h preceding an IVF cycle. Methods Men presenting with oligoasthenozoospermia or asthenozoospemia attempted three ejaculates within 24 h preceding IVF. Ejaculate 1 was produced the afternoon prior to oocyte retrieval, and ejaculates 2 and 3 were produced the morning of oocyte retrieval with 2-3 h between collections. Ejaculates 1 and 2 were extended 1:1 v/v with room temperature rTYBS. Test tubes were placed into a beaker of room temperature water, then placed at 4°C for gradual cooling. Ejaculate 3 was not extended, but pooled with ejaculates 1 and 2 and processed for intracytoplasmic sperm injection (ICSI). Results Out of 109 oocyte retrievals, 28 men were asked to attempt multiple consecutive ejaculations. Among this population, 25/28 (89.3 %) were successful, and 3/28 men (10.7 %) could only produce two ejaculates. Mean volumes for ejaculates 1, 2, and 3 were significantly different from each other (p<0.01); the volume decreased for each ejaculate. Mean sperm counts, motility, qualitative forward progression, and total motile cells per ejaculate for the ejaculates1, 2, and 3 demonstrated the following: ejaculates 2 and 3 were not significantly different, but counts, motility, and total motile sperm were improved over ejaculate 1 (p<0.01). Conclusions Pooling three consecutive ejaculates within 24 h increased the numbers of available motile sperm in this population by 8-fold compared to the first ejaculate alone, facilitating avoidance of sperm cryopreservation and additional centrifugation steps that could affect sperm viability and/or function.

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

“…(I), (II), (III)—Results were consistent among all the studies within all the groups. All studies (2063 males, 2560 samples) except for one in the Group (II) (25 males, 75 samples) [ 36 ] indicated that total sperm count was lower when abstinence time was shorter when comparing SAP with RAP. The same results were obtained when RAP was compared with LAP when assessed in volunteers [ 17 ] and patients with abnormal semen sample [ 35 ].…”

The use of pooled consecutive ejaculates in moderate male factor infertility to increase intrauterine insemination success

“…[ 13 14 15 ] Increase in PM without increase in sperm count was also noted by some. [ 16 17 18 19 20 ] Reported evidence is rather conflicting, and a similar improvement in parameters was not seen in all populations with some publications reporting reduction in total sperm count and volume and no improvement in concentration, PM, morphology, and DNA fragmentation index with daily ejaculation. [ 32 ] In our study, we observed a significantly lower volume but much higher sperm concentration and PM in the second consecutive ejaculates.…”

“…However, in 1990, it was surprisingly discovered that, when men were asked to produce a second sample within 1 or 2 h of ejaculation, reasonably good or in fact better samples were obtained; questioning the time honored correlation between abstinence and semen quality. [ 12 ] Improvements in either sperm counts[ 13 14 15 ] or PM[ 16 17 18 19 20 ] in consecutive ejaculates in oligospermic men have been reported in many subsequent publications. This combined and clear defining evidence questions the fundamental concepts in andrology and may pave the way for modified practice in future.…”

Necrozoospermia: The tree that hides the forest

“…12,39,40,161 The benefits from repeated ejaculations before ICSI have been demonstrated in patients with absolute immotile spermatozoa and with necrozoospermia. 161 Bar Hava et al 162 suggested an hour interval between two collections and Said et al 163 advised that patients ejaculate the day before oocyte retrieval and then collect two semen samples at an interval of 2 or 3 h.…”

“…Bar Hava et al 162 . suggested an hour interval between two collections and Said et al 163 . advised that patients ejaculate the day before oocyte retrieval and then collect two semen samples at an interval of 2 or 3 h.…”