Ashok Agarwal1, Sajal Gupta2, Stefan Du Plessis3, Rakesh Sharma2, Sandro C Esteves4, Caroline Cirenza5, Jasmine Eliwa6, Wedad Al-Najjar7, Deepika Kumaresan8, Namariq Haroun7, Sara Philby7, Edmund Sabanegh9. 1. American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH. Electronic address: agarwaa@ccf.org. 2. American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH. 3. American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH; Medical Physiology, Stellenbosch University, Tygerberg, South Africa. 4. ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, SP, Brazil. 5. American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH; Medical School University of Sao Paulo, Sao Paulo, Brazil. 6. American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH; Faculty of Medicine, Kuwait University. 7. American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH; Alfaisal University, Kingdom of Saudi Arabia. 8. American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH; Vinayaka Missions University, Tamil Nadu, India. 9. Department of Urology, Cleveland Clinic, Cleveland, OH.
Abstract
OBJECTIVE: To assess the effect of ejaculatory abstinence (EA) periods on routine and advanced sperm tests. METHODS: Men with normozoospermia provided semen samples after 1, 2, 5, 7, 9, and 11 days of abstinence. A standard semen analysis was performed on all samples. Each specimen was assessed for levels of reactive oxygen species (ROS) and sperm DNA fragmentation. Comparison was also made by grouping EA periods into short (1 day), recommended by World Health Organization (WHO) (2-7 days), and long (9-11 days). RESULTS: Semen volume (P < .001), sperm concentration (P < .001), and total sperm count (P < .001) increased significantly with abstinence length. Sperm DNA fragmentation was associated with the length of EA (P < .001). Both 1 and 2 days of EA had the least amount of DNA fragmentation (P < .001). Significant increase was seen in volume, pH, viscosity, total count, total motile sperm, and DNA fragmentation between short and recommended EA (P < .05), and between recommended and long EA (P < .05). Short EA had no detrimental impact on semen characteristics according to the 2010 WHO thresholds. CONCLUSION: Shortening of EA time is not detrimental to sperm quality in men with normozoospermia and is proposed as a method for reducing sperm DNA fragmentation. This strategy could help optimize sperm quality and the chances of natural and assisted conception. Accurate abstinence time should be considered when managing men with infertility problems with semen analyses even when it is within the recommended range.
OBJECTIVE: To assess the effect of ejaculatory abstinence (EA) periods on routine and advanced sperm tests. METHODS:Men with normozoospermia provided semen samples after 1, 2, 5, 7, 9, and 11 days of abstinence. A standard semen analysis was performed on all samples. Each specimen was assessed for levels of reactive oxygen species (ROS) and sperm DNA fragmentation. Comparison was also made by grouping EA periods into short (1 day), recommended by World Health Organization (WHO) (2-7 days), and long (9-11 days). RESULTS: Semen volume (P < .001), sperm concentration (P < .001), and total sperm count (P < .001) increased significantly with abstinence length. Sperm DNA fragmentation was associated with the length of EA (P < .001). Both 1 and 2 days of EA had the least amount of DNA fragmentation (P < .001). Significant increase was seen in volume, pH, viscosity, total count, total motile sperm, and DNA fragmentation between short and recommended EA (P < .05), and between recommended and long EA (P < .05). Short EA had no detrimental impact on semen characteristics according to the 2010 WHO thresholds. CONCLUSION: Shortening of EA time is not detrimental to sperm quality in men with normozoospermia and is proposed as a method for reducing sperm DNA fragmentation. This strategy could help optimize sperm quality and the chances of natural and assisted conception. Accurate abstinence time should be considered when managing men with infertility problems with semen analyses even when it is within the recommended range.
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