Enhancing Sperm Quality Through Consecutive Ejaculation After Short  Abstinence in Men with Low Semen Parameters Undergoing ICSI

Binarwan  Halim; Jesselyn  Angellee; Agustinus Agustinus; Cennikon  Pakpahan; Hilma Putri  Lubis

doi:10.18502/jri.v25i4.18126

Binarwan Halim Faculty of Medicine, Universitas Prima Indonesia, Medan, Indonesia
Jesselyn Angellee Halim Fertility Center, Stella Maris Women’s and Children’s Hospital, Medan, Indonesia
Agustinus Agustinus Andrology Study Program, Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Cennikon Pakpahan Andrology Study Program, Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Hilma Putri Lubis Department of Obstetrics and Gynecology, Division of Reproductive, Endocrinology and Infertility, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatra, Indonesia

DOI: https://doi.org/10.18502/jri.v25i4.18126

Keywords: Abstinence, Consecutive ejaculate, Embryo development, Semen quality, Sperm motility.

Abstract

Background: Longer abstinence time is believed to be associated with the production of reactive oxygen species (ROS), which in excessive amounts may be detrimental to the sperm. To enhance sperm quality, multiple research studies have proposed reducing the duration of abstinence by encouraging consecutive ejaculations. This approach has been shown to improve sperm motility and morphology, which are associated with better ICSI and IUI outcomes. The purpose of the current study was to evaluate sperm quality and fertilization rate, cleavage rate, as well as embryo quality in severe oligoasthenozoospermic men using the consecutive ejaculate collected within an hour of abstinence.

Methods: A prospective study was conducted at Halim Fertility Center from August 2020–April 2022, involving male partners undergoing ICSI treatment who presented with severe oligoasthenozoospermia on their previous semen analysis. The non-parametric Mann-Whitney and Wilcoxon tests were used to analyze the parameters of the groups, including characteristics of the study participants, oocytes and sperm samples, as well as the ICSI outcomes, using a significance level of 5%.

Results: A statistically significant improvement in the sperm total motility was recorded in the consecutive ejaculate compared to the first (31.53±11.73% vs. 22.52± 8.85%; p<0.001). Both fertilization and cleavage rates were higher in the consecutive ejaculate group, although they were not statistically significant (61.41±28.04% vs. 55.45±31.76%; p=0.081 and 88.10±28.63% vs. 81.07±36.34%; p=0.262).

Conclusion: Consecutive ejaculates collected within an hour of the first may enhance sperm total motility, fertility, and cleavage rates in male partners with low sperm count and quality undergoing ICSI treatment.