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Three hour abstinence as a treatment for high sperm DNA fragmentation: a prospective cohort study

  • Gamete Biology
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

This study sought to compare sperm DNA fragmentation (SDF) in semen specimens after 3 days and then after 3 h of abstinence in men presenting for initial infertility evaluation.

Methods

A prospective cohort study of 112 men undergoing their first semen analysis as part of an infertility work-up was conducted. All participants presented with 3 days of abstinence for a semen analysis and DNA-fragmentation test. Both tests were repeated on a second sample collected 3 h after the first ejaculation. DNA-fragmentation was evaluated with the halo test by one of two technicians blinded to duration of abstinence. Variables analyzed include ejaculate volume, sperm concentration and motility, smoking status, cannabis use, initial specimen DNA fragmentation, and use of sperm-directed anti-oxidant formulations.

Results

Among all subjects, DNA fragmentation improved in the 3-h abstinence specimen (34.6 ± 19.4% vs. 23.7 ± 16.0%, p = 0.0001). Among subjects with high DNA fragmentation (> 35%) on the initial specimen, 55% improved into the normal range. Semen volume and sperm concentration decreased (3.1 ± 3.3 ml vs. 1.9 ± 0.8 ml, p < 0.01 and 41 ± 39 vs. 32 ± 31 (millions/ml), p = 0.01), while progressive motility tended to increase. Fifty-eight subjects demonstrated ≥ 30% improvement in SDF in the second specimen as compared to the first. Factors found to correlate with > 30% improvement in DNA fragmentation in the 3-h abstinence specimen compared to 3 days were younger age and use of anti-oxidants.

Conclusion

High SDF can often be managed with a second ejaculation 3 h after the first in infertile couples, including in males with abnormal semen analyses per the 2010 WHO guide. Apart from SDF levels, changes in sperm quality were not clinically significant in the second specimen and did not increase rates of ICSI. However, a second ejaculation after 3 h probably may reduce the necessity of costly and/or invasive ART strategies.

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Funding

This study was funded by a grant from the Montreal Reproductive and Regenerative Medicine Foundation.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, McGill University Health Centre, Montreal, QC, Canada

    Michael H. Dahan & Seang Lin Tan

  2. Department of Obstetrics and Gynecology, MUHC Reproductive Center, McGill University, 888, Blvd. de Maisonneuve East, Suite 200, Montreal, QC, H2L 4S8, Canada

    Michael H. Dahan

  3. OriginElle fertility Clinic, 2110 Boul. Decarie, Montreal, QC, Canada

    Michael H. Dahan, Rabea Khoudja, Abbie Gagnon, Grace Tan & Seang Lin Tan

  4. University of Alberta, Calgary, AB, Canada

    Ginevra Mills

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  1. Michael H. Dahan
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Contributions

MHD, SLT, and GT conceived of the study. MHD and RK analyzed the data; AG, GT, and RK analyzed the DNA fragmentation or collected the data. MHD and GM wrote the article. GT, SLT, and RK edited the article. Both MHD and GM acted as the primary or first author for this study.

Corresponding author

Correspondence to Michael H. Dahan.

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The authors declare that they have no conflicts of interest.

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Both Ginevra Mills and Michael H. Dahan acted as the first author for this article.

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Dahan, M.H., Mills, G., Khoudja, R. et al. Three hour abstinence as a treatment for high sperm DNA fragmentation: a prospective cohort study. J Assist Reprod Genet 38, 227–233 (2021). https://doi.org/10.1007/s10815-020-01999-w

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  • DOI: https://doi.org/10.1007/s10815-020-01999-w

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