Evaluating Semen Parameters for Predictive Correlations Between Fresh and Delayed Analysis Using an At-Home Semen...

Male factor infertility contributes to nearly half of all infertility cases, yet timely semen analysis is often hindered by logistical and psychosocial barriers. The standard recommendation for in-clinic analysis within 1 hr post-ejaculation limits access, prompting interest in at-home semen collection and mail-in testing solutions. This prospective study evaluates the Give Legacy At-Home Semen Collection Kit for its ability to preserve semen quality over time and assesses whether delayed analyses (up to 48 hr post-ejaculation) can reliably predict baseline semen parameters. Thirty participants provided 60 semen samples analyzed across five timepoints (T0: 30 min, T1: 1 hr, T2: 6 hr, T3: 24 hr, T4: 30 hr). Total and progressive motility declined over time, with the greatest reductions after 6 hr. At baseline, high total motile sperm count (TOMO) individuals exhibited significantly greater motility than those in the low TOMO group and retained relatively higher motility across time points. Predictive models using delayed data (T1-T4) accurately estimated baseline motility values, with strong performance metrics (e.g., progressive motility model: mean absolute error [MAE] = 7.31, root mean squared error [RMSE] = 11.15, r = .86, intraclass correlation coefficient [ICC] = .74). These findings suggest that semen degradation during transit is predictable and that baseline motility can be reconstructed with clinically acceptable accuracy. This study supports the clinical utility of at-home semen collection and mail-in analysis for male fertility assessment. Predictive modeling enables diagnostic insights even when testing is delayed, expanding access while maintaining diagnostic integrity. Future research should explore broader populations and integrate additional fertility biomarkers.