1
|
Du C, Li Y, Yin C, Luo X, Pan X. Association of abstinence time with semen quality and fertility outcomes: a systematic review and dose-response meta-analysis. Andrology 2024; 12:1224-1235. [PMID: 38197853 DOI: 10.1111/andr.13583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Infertility affects 186 million people worldwide, with male factors contributing to 50% of infertility cases. Semen analysis is a key for diagnosing male factor infertility, but sperm parameters can be influenced by ejaculatory abstinence (EA) duration. Shortening or prolonging EA can impact on semen quality and assisted reproductive technology (ART) outcomes, but the optimal EA duration remains unclear, particularly for infertility patients. OBJECTIVES This study conducts a comprehensive meta-analysis to explore the impact of varying abstinence durations on semen quality and fertility outcomes. METHODS Three English database (PubMed, Embase, and Cochrane Central Register of Controlled Trials) as well as four Chinese database (China National Knowledge Infrastructure, Chinese Scientific Journals database, WanFang database, and Chinese Biomedical Literature database) were searched from 2000 to August 2023. The classical meta-analysis and "one-stage" dose-response meta-analysis were conducted to compare the associations of different abstinence durations (short-term abstinence vs. long-term abstinence) on semen quality in healthy adult and different type of infertile patients. RESULTS There were 85 eligible studies were finally included. The meta-analysis of volume (mean difference [MD] = -0.95 mL, 95% confidence interval [CI]: -1.16 to -0.74 mL), total sperm count (TSC) (MD = -102.45×106, 95% CI: -117.98×106 to -86.91×106), sperm concentration (SC) (MD = -11.88×106/mL, 95% CI: -18.96×106/mL to -4.80×106/mL), DNA fragmentation index (DFI) (MD = -2.37%, 95% CI: -4.73% to -0.01%) in healthy men showed a significant decrease with different abstinence durations (short-term abstinence vs. long-term abstinence). The meta-analysis of infertile men showed significant decrease in volume in various subgroups (MD range: -0.73 to -1.17 mL) with P < 0.01; TSC (MD = -61.93×106, 95% CI: -88.84×106 to -35.01×106), SC (MD = -5.39×106/mL, 95% CI: -9.97×106 to -0.81×106/mL), DFI (MD = -5.63%, 95% CI: -10.19% to -1.06%) in unexplained infertility subgroup; significant increase in viability (MD = 6.14%, 95% CI: 3.61% to 8.68%) in the unexplained infertility subgroup. The dose-response meta-analysis showed that TSC in oligozoospermia showed a nonlinear increase (coefficient from 3.38 to -5.76, P from 0.02 to 0.22) and the truncation point was around the 4th to 5th abstinence day. The percentage of progressive motile sperm (PR) in asthenozoospermia showed a significant decrease (coefficient = -2.39, 95% CI: -4.28 to -0.50). For fertility outcomes of different ARTs, only the clinical pregnancy rate (CPR) in the intrauterine insemination (IUI) subgroup showed a significant decrease around the 3rd day (coefficient = 0.85, 95% CI: 0.75 to 0.97). CONCLUSIONS Short-term abstinence may be associated with limited improvements in semen quality in healthy men but could be more beneficial for infertile men, especially within the first 4 days of abstinence. Caution is urged in making definitive conclusions about the causal relationship between abstinence time and semen quality changes due to potential confounding and interactions.
Collapse
Affiliation(s)
- Chengchao Du
- Department of Reproductive Andrology & Sichuan Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Yi Li
- Department of Pain Management, West China Hospital, Sichuan University, Chengdu, China
| | - Chongyang Yin
- School of Integrated Education, YiBin Vocational and Technical College, Yibin, China
| | - Xuefeng Luo
- Department of Reproductive Andrology & Sichuan Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Xiangcheng Pan
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
2
|
Shaikh R, More A, Dutta S, Choudhary N, Khemani S. The Influence of Abstinence Interval on Semen Quality and Its Effect on an Assisted Reproductive Technology (ART) Pregnancy: A Case Report. Cureus 2024; 16:e54226. [PMID: 38496096 PMCID: PMC10943567 DOI: 10.7759/cureus.54226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/15/2024] [Indexed: 03/19/2024] Open
Abstract
This case report focuses on a couple facing primary infertility, where the male partner exhibited asthenoteratozoospermia and high DNA fragmentation. The treatment approach involved three cycles of intracytoplasmic sperm injection (ICSI), an assisted reproductive technology (ART), to indicate and address the specific challenges posed by male factor infertility. The initial two attempts failed as DNA fragmentation was high, which was observed on days 4 and 3 of abstinence, respectively. In the third cycle, DNA fragmentation was low on day 2 of the abstinence period, resulting in the successful formation and cryopreservation of embryos. Subsequently, three months later, frozen embryo transfer (ET) was done. This was followed by a positive β-human chorionic gonadotropin (hCG) test after 14 days that confirmed biochemical pregnancy, and successful conception was determined by ultrasound detection of the visible sac with fetal pole. This report underscores the critical importance of treatment plans for individual patients, especially considering the impact of abstinence periods on sperm DNA fragmentation. The findings promote a personalized approach to assisted reproductive techniques, enhancing the success rate. It is recommended that further comprehensive studies be conducted to validate and anticipate these observations.
Collapse
Affiliation(s)
- Rokaiya Shaikh
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Akash More
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shilpa Dutta
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Namrata Choudhary
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shivani Khemani
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
3
|
Cermisoni GC, Minetto S, Marzanati D, Alteri A, Salmeri N, Rabellotti E, Nova A, Salonia A, Pozzi E, Candiani M, Papaleo E, Pagliardini L. Effect of ejaculatory abstinence period on fertilization and clinical outcomes in ICSI cycles: a retrospective analysis. Reprod Biomed Online 2024; 48:103401. [PMID: 37976657 DOI: 10.1016/j.rbmo.2023.103401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/08/2023] [Accepted: 09/05/2023] [Indexed: 11/19/2023]
Abstract
RESEARCH QUESTION Does ejaculatory abstinence impact fertilization outcomes in intracytoplasmic sperm injection (ICSI) cycles in infertile couples? DESIGN This single-centre retrospective observational study included 6919 ICSI cycles from 2013 to 2022. The primary outcome was the assessment of oocyte fertilization, measured in terms of the rate of formation of two-pronuclear (2PN), 3PN and 1PN zygotes. Secondary outcomes were blastulation, cumulative positive β-human chorionic gonadotrophin test and clinical pregnancy rates. Relationships between ejaculatory abstinence and fertilization outcomes, and ejaculatory abstinence and clinical outcomes were evaluated with multivariable analysis, including possible confounders. RESULTS A positive association was observed between ejaculatory abstinence and semen sample volume (P < 0.001), sperm concentration (P < 0.001) and total motile sperm count (P < 0.001). No association was found between the 1PN zygote rate and ejaculatory abstinence (P = 0.97). Conversely, for each additional day of ejaculatory abstinence, the likelihood of obtaining 2PN zygotes from all inseminated oocytes decreased by 3% [adjusted odds ratio (aOR) 0.97, 95% CI 0.94-0.99], whilst the likelihood of obtaining 3PN zygotes from all inseminated oocytes increased significantly by 14% (aOR 1.14, 95% CI 1.07-1.22). No significant associations were found between ejaculatory abstinence and blastulation, cumulative pregnancy or miscarriage rates. CONCLUSIONS A longer ejaculatory abstinence period significantly decreases the rate of 2PN zygotes, and increases the rate of 3PN zygotes without directly affect blastulation and pregnancy rates.
Collapse
Affiliation(s)
- G C Cermisoni
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - S Minetto
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - D Marzanati
- Reproductive Sciences Laboratory, Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Alteri
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - N Salmeri
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - E Rabellotti
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Nova
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - A Salonia
- University Vita-Salute San Raffaele, Milan, Italy; Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - E Pozzi
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - M Candiani
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - E Papaleo
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Pagliardini
- Reproductive Sciences Laboratory, Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.
| |
Collapse
|
4
|
Barbagallo F, Cannarella R, Crafa A, La Vignera S, Condorelli RA, Manna C, Calogero AE. The Impact of a Very Short Abstinence Period on Assisted Reproductive Technique Outcomes: A Systematic Review and Meta-Analysis. Antioxidants (Basel) 2023; 12:antiox12030752. [PMID: 36979001 PMCID: PMC10045034 DOI: 10.3390/antiox12030752] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Previous studies supported the beneficial effects of a very short abstinence period on sperm quality. This systematic review and meta-analysis aimed to evaluate the effects of a very short abstinence period (within 4 h) on assisted reproductive technique (ART) outcomes. METHODS A literature search was performed using the Pubmed, Scopus, Web of Science, and Cochrane databases. A meta-analysis was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) for randomized controlled trials (RCTs). All eligible studies were selected following the PICOS (Population, Intervention, Comparison/Comparator, Outcomes, Study type) model. The following pregnancy outcomes after ART were considered: fertilization rate (FR), implantation rate (IR), clinical pregnancy rate (CPR), live birth rate (LBR), and miscarriage rate (MR). This study was registered on PROSPERO (CRD42023396429). RESULTS We evaluated 414 records for eligibility, and 7 studies were ultimately included. Our analysis showed that a very short abstinence period significantly increased the IR, CPR, and LBR after ART. No significant differences were found for the FR and MR. CONCLUSIONS A second ejaculation collected very shortly after the first one could represent a simple strategy to improve the results of ART, especially in couples including patients with abnormal sperm parameters.
Collapse
Affiliation(s)
- Federica Barbagallo
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Claudio Manna
- Biofertility IVF and Infertility Center, 00198 Rome, Italy
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| |
Collapse
|
5
|
The Influence of Male Ejaculatory Abstinence Time on Pregnancy Rate, Live Birth Rate and DNA Fragmentation: A Systematic Review. J Clin Med 2023; 12:jcm12062219. [PMID: 36983220 PMCID: PMC10054513 DOI: 10.3390/jcm12062219] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/09/2023] [Accepted: 03/11/2023] [Indexed: 03/15/2023] Open
Abstract
Variation in ejaculatory abstinence time and its influence on semen quality and clinical reproductive outcomes is a growing concern among clinicians and researchers. The WHO (World Health Organization) recommends 2–7 days of abstinence time prior to semen collection for diagnostic purposes; however, the evidence that such an abstinence period leads to better pregnancy outcomes remains unclear. The aim of this systematic review is to evaluate short and long ejaculatory abstinence time in association with pregnancy rate, live birth rate and DNA fragmentation, in order to make a recommendation on an ideal timeframe for ejaculatory abstinence. This review is conducted according to the PRISMA guidelines and registered in PROSPERO (CRD42022379039). The electronic databases PubMed, Embase and Cochrane were searched for eligible studies. The Scottish Intercollegiate Guidelines Network was used for the assessment of the risk of bias across the included studies. Twenty-four studies were included in this systematic review. The included studies confirm that a shorter abstinence time is associated with improved pregnancy rates and live birth rates following assisted reproductive technology compared with longer ejaculatory abstinence times at different cut-off points. Similarly, a lower DNA fragmentation index was reported in semen analyses collected from short abstinence times compared with long abstinence times. However, due to the heterogeneity of the included studies, it is not possible to extract an ideal time of ejaculatory abstinence, but all outcomes improved with shorter ejaculatory abstinence times. This systematic review confirms that short ejaculatory abstinence times, less than those recommended by the WHO for diagnostic purposes, are associated with higher pregnancy and live birth rates and improved DNA fragmentation, when compared to long ejaculatory abstinence times.
Collapse
|
6
|
Barbagallo F, Cannarella R, Crafa A, Manna C, La Vignera S, Condorelli RA, Calogero AE. The Impact of a Very Short Abstinence Period on Conventional Sperm Parameters and Sperm DNA Fragmentation: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11247303. [PMID: 36555920 PMCID: PMC9782170 DOI: 10.3390/jcm11247303] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE In recent years, a growing number of studies have supported the beneficial effects of a very short abstinence period on sperm parameters, especially in patients with oligoasthenozoospermia. However, the results are controversial and no consensus exists regarding whether to request a second semen collection in clinical practice. Therefore, this systematic review and meta-analysis aimed to evaluate the influence of a very short abstinence period (within 4 h) on conventional sperm parameters and sperm DNA fragmentation (SDF) rate. MATERIALS AND METHODS The literature search was performed using Scopus and PubMed databases. The meta-analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P) guidelines. All eligible studies were selected according to the Population, Intervention, Comparison/Comparator, Outcomes, and Study design (PICOS) model. The quality of evidence of the included studies was analyzed through the Cambridge Quality Checklists. The standardized mean difference (SMD) was used to analyze the outcomes. Cochran-Q and I2 statistics were used to evaluate statistical heterogeneity. RESULTS We assessed for eligibility 1334 abstracts, and 19 studies were finally included. All 19 articles evaluated the effects of a very short abstinence period on sperm parameters and, among these, 5 articles also evaluated the effects on SDF rate. The quantitative analysis showed a significant reduction in semen volume after a very short abstinence period in both normozoospermic men and patients with oligozoospermia, asthenozoospermia, and/or teratozoospermia (OAT) patients. We found a statistically significant increase in sperm concentration and total and progressive motility in the second ejaculation of patients with OAT. In contrast, the SDF rate decreased significantly in the second ejaculate of OAT patients. CONCLUSIONS This is the first systematic review and meta-analysis investigating the impact of a very short abstinence period on sperm parameters and SDF rate. The results suggest that collecting a second consecutive ejaculation after a very short time from the first could represent a simple and useful strategy for obtaining better-quality spermatozoa, especially in patients with abnormal sperm parameters.
Collapse
Affiliation(s)
- Federica Barbagallo
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Claudio Manna
- Biofertility IVF and Infertility Center, 00198 Rome, Italy
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Rosita A. Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
- Correspondence:
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| |
Collapse
|
7
|
Meitei HY, Uppangala S, Lakshmi RV, Guddattu V, Hegde P, Kumar P, Adiga P, Kalthur G, Schlatt S, Adiga SK. Sperm characteristics in normal and abnormal ejaculates are differently influenced by length of ejaculatory abstinence. Andrology 2022; 10:1351-1360. [PMID: 35776678 DOI: 10.1111/andr.13222] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 05/06/2022] [Accepted: 06/24/2022] [Indexed: 11/29/2022]
Abstract
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 sperm-preparation methods in a large number of sub-fertile men undergoing infertility workups. MATERIALS AND METHODS This retrospective registry-based cohort study analyzed the data of 10,674 ejaculates from 7,972 sub-fertile men, who were then segregated into normozoospermic, oligozoospermic, asthenozoospermic, and oligo-asthenozoospermic cohorts. Variations in semen characteristics and post-wash outcomes were studied between 4 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 number 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 oligoasthenozoopermic cohort (p < 0.05). In the normozoospermic cohort, a longer LEA led to fewer sperm with amorphous heads but more sperm 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 normozoopsermic 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. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Huidrom Yaiphaba Meitei
- Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Shubhashree Uppangala
- Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - R Vani Lakshmi
- Department of Data Science, Prasanna School of Public health, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Vasudeva Guddattu
- Department of Data Science, Prasanna School of Public health, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Padmaraj Hegde
- Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Pratap Kumar
- Department of Reproductive Medicine and Surgery, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Prashanth Adiga
- Department of Reproductive Medicine and Surgery, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Guruprasad Kalthur
- Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Stefan Schlatt
- Centre of Reproductive Medicine and Andrology (CeRA), University of Münster, Münster, Germany
| | - Satish Kumar Adiga
- Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| |
Collapse
|
8
|
Barbagallo F, Calogero AE, Condorelli RA, Farrag A, Jannini EA, La Vignera S, Manna C. Does a Very Short Length of Abstinence Improve Assisted Reproductive Technique Outcomes in Infertile Patients with Severe Oligo-Asthenozoospermia? J Clin Med 2021; 10:4399. [PMID: 34640416 PMCID: PMC8509843 DOI: 10.3390/jcm10194399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/04/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022] Open
Abstract
In recent years, a growing number of studies seem to support the beneficial effects of a very short abstinence period on sperm parameters, especially in patients with oligo-asthenozoospermia (OA). On this basis, the aim of this study was to evaluate the effects of a short period of abstinence (1 h) on intracytoplasmic sperm injection (ICSI) outcomes in infertile patients with severe OA. We performed a retrospective study on 313 ICSI cycles in which couples were divided into two different groups based on sperm parameters of the male partners. Group 1 included normozoospermic men or male partners with a mild OA (n = 223). Group 2 included male partners with severe OA (n = 90). They were asked to provide a second consecutive ejaculation after 1 h from the first one. The best ejaculate was used to perform ICSI. We found a significant increase of total (p < 0.001) and progressive motility (p < 0.001) in the second ejaculate of patients of Group 2 compared with those of the first one. Spermatozoa of the second ejaculate were chosen for ICSI for all patients in Group 2. We found statistically significant improvement of clinical pregnancy rate (p = 0.001) and embryo quality (p = 0.003) in couples in Group 2 compared to those of Group 1. No statistically significant difference was found in fertilization, implantation, live birth delivery, and miscarriage rates between the two groups. Therefore, a second semen sample collected after a very short time-interval in patients with severe OA allowed us to obtain significantly higher clinical pregnancy rate with improved embryo quality compared to normozoospermic men or patients with mild OA. Fertilization, implantation, live birth delivery, and miscarriage rates were similar between the two groups. The present study shows that a second consecutive ejaculate could represent a simple strategy to obtain better sperm parameters and assisted reproductive technology (ART) outcomes in infertile patients with mild-severe OA.
Collapse
Affiliation(s)
- Federica Barbagallo
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (F.B.); (A.E.C.); (R.A.C.); (S.L.V.)
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (F.B.); (A.E.C.); (R.A.C.); (S.L.V.)
| | - Rosita A. Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (F.B.); (A.E.C.); (R.A.C.); (S.L.V.)
| | - Ashraf Farrag
- Biofertility IVF and Infertility Center, 00198 Rome, Italy;
| | - Emmanuele A. Jannini
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy; (F.B.); (A.E.C.); (R.A.C.); (S.L.V.)
| | - Claudio Manna
- Biofertility IVF and Infertility Center, 00198 Rome, Italy;
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy
| |
Collapse
|
9
|
Male sperm storage impairs sperm quality in the zebrafish. Sci Rep 2021; 11:16689. [PMID: 34404815 PMCID: PMC8371167 DOI: 10.1038/s41598-021-94976-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 07/19/2021] [Indexed: 01/03/2023] Open
Abstract
Variation in sperm traits is widely documented both at inter- and intraspecific level. However, sperm traits vary also between ejaculates of the same male, due for example, to fluctuations in female availability. Variability in the opportunities to mate can indeed have important consequences for sperm traits, as it determines how often sperm are used, and thus the rate at which they are produced and how long they are stored before the mating. While being stored within males’ bodies, sperm are subjected to ageing due to oxidative stress. Sperm storage may significantly impair sperm quality, but evidence linking male sperm storage and variation in sperm traits is still scarce. Here, we tested the effect of the duration of sperm storage on within-male variation in sperm traits in the zebrafish, Danio rerio. We found that without mating opportunities, sperm number increased as storage duration increased, indicating that sperm continue to be produced and accumulate over time within males without being discharged in another way. Long sperm storage (12 days) was associated with an overall impairment in sperm quality, namely sperm motility, sperm longevity, and sperm DNA fragmentation, indicating that sperm aged, and their quality declined during storage. Our results confirm that male sperm storage may generate substantial variation in sperm phenotype, a source of variation which is usually neglected but that should be accounted for in experimental protocols aiming to assay sperm traits or maximise fertilization success.
Collapse
|
10
|
Sokol P, Drakopoulos P, Polyzos NP. The Effect of Ejaculatory Abstinence Interval on Sperm Parameters and Clinical Outcome of ART. A Systematic Review of the Literature. J Clin Med 2021; 10:3213. [PMID: 34361997 PMCID: PMC8347289 DOI: 10.3390/jcm10153213] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/06/2021] [Accepted: 07/14/2021] [Indexed: 12/18/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Piotr Sokol
- Department of Reproductive Medicine, Dexeus University Hospital, 08028 Barcelona, Spain;
| | - Panagiotis Drakopoulos
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium;
- Centre for Reproductive Medicine, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Nikolaos P. Polyzos
- Department of Reproductive Medicine, Dexeus University Hospital, 08028 Barcelona, Spain;
- Faculty of Medicine and Health Sciences, University of Ghent (UZ Gent), 9000 Gent, Belgium
| |
Collapse
|
11
|
Alipour H, Duus RK, Wimmer R, Dardmeh F, Du Plessis SS, Jørgensen N, Christiansen OB, Hnida C, Nielsen HI, Van Der Horst G. Seminal plasma metabolomics profiles following long (4-7 days) and short (2 h) sexual abstinence periods. Eur J Obstet Gynecol Reprod Biol 2021; 264:178-183. [PMID: 34325212 DOI: 10.1016/j.ejogrb.2021.07.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Metabolomic profiling of seminal plasma has been suggested as a possible approach for a fast and non-invasive male infertility evaluation diagnosis. However, metabolomics profiles in normozoospermic men have not been thoroughly investigated, and the influence of ejaculation-abstinence has not been described. To provide interim reference values and find associations between the metabolomics profiles of human seminal plasma and length of ejaculation-abstinence period in normozoospermic men. STUDY DESIGN Semen samples collected after long (4-7 days) and short abstinence (2 h) from 31 normozoospermic males were assessed for routine quality parameters before the seminal plasma was separated by centrifugation. Metabolomics profiles of the seminal plasma were then determined using untargeted Nuclear Magnetic Resonance Spectroscopy. RESULTS In total, 30 metabolites were identified. Pyruvate showed a higher concentration, while fructose, acetate, choline, methanol, N-acetylglucosamine, O-acetylcarnitine, uridine, and sn-glycero-3-phosphocoline showed lower concentrations in samples collected after short abstinence (vs. long). All metabolites showed lower absolute amounts (volume × concentration) following shorter abstinence. However, the lower sperm concentration in samples collected after short abstinence resulted in higher absolute amounts of pyruvate and taurine per spermatozoa: pyruvate 1.92 (1.12-3.87) vs. 1.29 (0.83-2.62) (P < 0.001) and taurine 0.58 (0.36-0.92) vs. 0.43 (0.28-0.95) (P < 0.05) ng/106 spermatozoa. Simultaneously, there was a higher percentage of progressively motile spermatozoa in samples collected after the short abstinence. CONCLUSION The generally lower concentrations of seminal metabolites after short abstinence periods may be related to the shorter time available for secretion and collection of these metabolites by the accessory glands and the epididymides. The concomitant lower number of spermatozoa in the second ejaculate resulted in increased absolute amounts of pyruvate and taurine per spermatozoa, accompanied by increased spermatozoa motility in these samples. The simultaneous increase in percentages of motile spermatozoa and absolute amounts of pyruvate and taurine per spermatozoa after shorter abstinence might indicate that these two metabolites play a more critical role in sperm motility, which should be further investigated in future studies.
Collapse
Affiliation(s)
- H Alipour
- Department of Health Science and Technology, Regenerative Medicine Group, Aalborg University, Aalborg, Denmark.
| | - R K Duus
- Department of Health Science and Technology, Regenerative Medicine Group, Aalborg University, Aalborg, Denmark
| | - R Wimmer
- Department of Chemistry and Bioscience, Aalborg University, Aalborg, Denmark
| | - F Dardmeh
- Department of Health Science and Technology, Regenerative Medicine Group, Aalborg University, Aalborg, Denmark
| | - S S Du Plessis
- Department of Basic Medical Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates; Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - N Jørgensen
- University Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Copenhagen, Denmark
| | - O B Christiansen
- Department of Obstetrics and Gynecology, Fertility Unit, Aalborg University Hospital, Aalborg, Denmark; Institute of Clinical Medicine, Aalborg University, Denmark
| | - C Hnida
- Department of Obstetrics and Gynecology, Fertility Unit, Aalborg University Hospital, Aalborg, Denmark
| | - H I Nielsen
- Department of Health Science and Technology, Regenerative Medicine Group, Aalborg University, Aalborg, Denmark
| | - G Van Der Horst
- Department of Medical Biosciences, University of the Western Cape, Cape Town, South Africa
| |
Collapse
|
12
|
Ciotti PM, Calza N, Zuffa S, Notarangelo L, Nardi E, Damiano G, Cipriani L, Porcu E. Two subsequent seminal productions: A good strategy to treat very severe oligoasthenoteratozoospermic infertile couples. Andrology 2021; 9:1185-1191. [PMID: 33861504 DOI: 10.1111/andr.13020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/16/2021] [Accepted: 04/08/2021] [Indexed: 12/28/2022]
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 × 106 /mL no progressive motility; count ≥0.2 × 106 /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.
Collapse
Affiliation(s)
- Patrizia Maria Ciotti
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Nilla Calza
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Silvia Zuffa
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Leonardo Notarangelo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Elena Nardi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Giuseppe Damiano
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Linda Cipriani
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Eleonora Porcu
- Infertility and IVF Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| |
Collapse
|