Increased pregnancy after reduced male abstinence

Area of Science:

• Reproductive Medicine
• Andrology
• Genetics

Background:

• Sperm DNA fragmentation (SDF) is a key factor affecting male fertility and intracytoplasmic injection (ICSI) success rates.
• Traditional protocols often involve prolonged periods of abstinence, which may not optimize sperm quality for assisted reproductive technologies.

Purpose of the Study:

• To investigate whether recurrent ejaculation (REC) followed by sperm selection reduces SDF and improves pregnancy rates compared to traditional abstinence (ABS) protocols in ICSI cycles.
• To assess the impact of a specific REC regimen (daily ejaculation for four days, then 12-hour abstinence) on semen parameters and subsequent fertility outcomes.

Main Methods:

• Forty couples undergoing ICSI followed a REC protocol (4 days of daily ejaculation, then 12-hour abstinence).
• Sperm samples were analyzed for volume, concentration, motility, and SDF.
• Pregnancy rates were compared between the REC group and a control group (150 couples) using a 4-day ABS protocol.
• Sperm selection was performed using density gradient centrifugation before ICSI.

Main Results:

• The REC group showed a significant decrease in semen volume (67%) and SDF (27%) after sperm selection.
• Sperm motility and concentration remained unchanged in the REC group.
• The REC group achieved a significantly higher pregnancy rate (56.4%) compared to the ABS control group (43.3%, p=0.030).

Conclusions:

• A regimen of recurrent ejaculation for four days with a 12-hour final abstinence, combined with density gradient centrifugation sperm selection, significantly enhances ICSI pregnancy rates.
• The reduction in sperm DNA fragmentation is proposed as the primary mechanism driving the improved reproductive outcomes in ICSI.
• This study suggests that optimizing ejaculation frequency can be a valuable strategy in male infertility management for assisted reproduction.